Extraluminal valvuloplasty

Vene-preserving surgical method for the treatment of truncal venous insufficiency. The procedure aims at repairing the deficient closure function of the sluice valves (usually the crosses of the saphenous vein) by artificially narrowing the (enlarged) vein diameter. The varicose, dilated vein is mechanically constricted until the reflux coming from the deep vein stops again. This is usually the case with a vein diameter of 0.6 cm. The normalization of the hemodynamics in the cross region leads to a retonation of the peripheral vein sections.

In detail, an individually cut, 4x2cm plastic patch with a U-shaped recess is placed around the vena saphena magna in the shape of a cuff. Under Valsalva maneuvers (reflux control) the Cossen region is increasingly constricted until the physiologically closing valve function can resume. The suspension of reflux from the indicator vein indicates sufficient valve closure. The cuff around the saphenous vein is then fixed with single button sutures.

1. Lane RJ et al (2002) The treatment of varicose veins with external stenting to the saphenofemoral junction.Vasc endovascular surgery 36:179-192.
2. Mumme A et al. (2010) Venous valve reconstruction in stem insufficiency of VSM. In: T Noppeney, H Nüllen Diagnosis and therapy of varicosis. Springer Medicine Publishing House Heidelberg S 360-363
3. Stücker M et al (2013) New concept: different types of insufficiency of the saphenofemoral junction identified by duplex as a chance for a more differentiated therapy of the great saphenous vein. Phlebology 28:268-274.