Autogenous venous valve construction.

Aim: The aim of this study was to assess the results of a new type of antireflux operation on the deep venous system in patients with venous ulceration not responding to treatment of the superficial system and compression.

Methods: In the period comprised between 1991-2002, the authors treated 56 patients with venous ulceration by Fegan's technique, that consists in compression sclerotherapy combined with antireflux operation of the deep veins. All patients selected had pathological reflux in the deep venous system and their ulcers did not respond to superficial and perforating vein therapy, and elastic compression.

Results: Using this technique of complex antireflux treatment, it was possible to heal 53 (95.4%) of the 56 ulcers with average time of complete ulcer epitelisation within 39+/-12 days. The recurrence rate, within the 5 year follow-up was 18% (10 patients), but 7 of the recurrent ulcers responded to compression sclerotherapy and healed within 3 months.

Conclusions: In situ made valvuloplasty has several advantages: the valve is constructed from autogenous vein wall; all luminal valve surfaces have native venous endothelium; intraluminal foreign material is not introduced; the likelihood of thrombosis is reduced; the valve is size-matched to the host vein and this technique provides a competent bicuspid valve.