External banding valvuloplasty of the superficial femoral vein in the treatment of recurrent varicose veins.

Objectives: The aim of this study is to evaluate the efficacy of reconstructive surgery of primary deep venous insufficiency in preventing recurrent varicose veins.

Design: Retrospective analysis of patients affected by recurrent varicose veins submitted to external banding valvuloplasty of the superficial femoral vein.

Setting: A division of vascular surgery in a hospital/scientific institute.

Materials: Nineteen limbs (19 patients) with recurrent varicose veins, severe chronic venous insufficiency and 3rd or 4th grade reflux in the superficial femoral vein and competence of the profunda femoris vein were selected for surgical reconstructive treatment after a complete diagnostic study by continuous wave Doppler duplex scanning and descending phlebography.

Interventions: External banding valvuloplasty of the superficial femoral vein was performed in all cases: A Dacron sleeve was used in nine patients and Venocuff in 10.

Results: In one case a deep venous thrombosis of the calf occurred in the first postoperative period; in three cases the correction of the deep reflux was incomplete and a recurrence of the varices was observed. After a mean follow-up of 50 months, abolition of reflux and relief of symptomatology were obtained in 15 cases (78%).

Conclusions: Primary deep venous insufficiency, unknown at the time of the initial operation, may be the cause of recurrent varicose veins. External banding valvuloplasty of the superficial femoral vein may abolish the reflux and correct venous hypertension, preventing recurrences.