Superficial Femoral Vein Valve Repair with Limited Anterior Plication

Abstract

Objective: To evaluate the effects after 3 years of a new surgical technique, limited anterior plication (LAP) of the superficial femoral vein. Design: Patients with venous hypertension resulting from deep and superficial venous incompetence were randomized into two treatment groups. Setting: Angiology and Vascular Surgery, Pierangeli Clinic, Pescara, and Cardiovascular Institute, Chieti University, Italy. Patients: Both groups were treated with superficial vein surgery. Group 2 was also treated with LAP. Interventions: Valvuloplasty of the superficial femoral vein was performed with plication of the anterior vein wall after limited dissection of the vein. Main outcome measures: During a 3-year follow-up results were evaluated with colour duplex and ambulatory venous pressure (AVP) measurements. Endpoints were AVP, refilling time (RT), number of incompetent venous sites, presence/absence of the reflux at the superficial femoral vein and the diameter of the vein. Results: No complications were observed. All femoral veins treated with LAP were competent at 36 months. Significantly lower AVP and longer RT were observed in the LAP group. The number of incompetent venous sites was lower in both groups. The average diameter of the vein was higher in Group 1. Conclusions: In selected subjects – moderate deep venous incompetence, functional cusps, incompetence mainly due to relative enlargement of the vein – LAP may be an alternative to external valvuloplasty.