Femoral vein valve external support under phleboscopy

The effectiveness of external valve support using A.N. Vedensky Spirals for primary deep vein reflux depends on superficial femoral vein (SFV) ostial valve anatomy was studied. Pre-ostail and ostial valves of superficial femoral vein (56 valves) were investigated using phleboscopy. Majority of investigated valves (51,1% of ostial and 96,4% pre-ostial valves) were presented by wide separated two cusps type anatomy. The ostial or ostial and preostial valves of SFV were repaired depends on the anatomy of ostial valve. The ostial valve was repaired if valve presented by wide separated two cusps type anatomy. Ostial and preostial valves were repaired if ostial valve presented by elongated two cusps or mono cusp type anatomy. After Spiral with internal diameter of 7-8 mm applied using Vedensky technique on the valve area the vein diameter decreased on 31,4%-33,3% of preoperative diameter (measured in standing position during Valsalva maneuver) reflux duration time in limbs with wide separated two cusps type anatomy 0,46+0,19 became significantly less than the reflux duration time in limbs with another types of anatomy 0,65±0,14 (t=2,376; p=0,042). No reflux below reconstructed vein segment was presented. It was confirmed by descending phlebography. The success of external valve repair depends on adequate selecting size of Spirals and anatomical status of repairing valve. Number of repairing valves depends on the anatomy of superficial femoral vein ostial valve.