Internal valvuloplasty combined with sleeve wrapping in the treatment of severe deep venous incompetence: A case report. (February 2022)

• Record Type: Journal Article
• Authors: Wu, Yingfeng; Wei, Libing; Gao, Xixiang; Qi, Yixia; Tong, Zhu; Gu, Yongquan; Hua, Yang; Wang, Lili; Wang, Wei; Guo, Lianrui
• Is Part Of: Vascular. Volume 30:Number 1(2022)
• Page Start: 115
• Page End: 119
• Publication Date: 2022-02
• Subjects: Valvuloplasty -- chronic venous insufficiency -- deep venous incompetence -- deep venous reconstructions; 616.13
• DOI: 10.1177/1708538121990121
• Languages: English
• ISSNs: 1708-5381

Abstract

Background: The main cause of severe chronic venous insufficiency is deep venous incompetence. Deep venous reconstructive surgeries are reserved for cases that do not show a good response to conservative therapies. Method: We present the case of a 68-year-old man presenting with swelling, pain, and pigmentation in his left lower limb for 14 years and ulcers for 10 years. Descending venography identified a Kistner's grade IV reflux in the deep vein of the left lower limb. Internal valvuloplasty was performed following Kistner's method. Meanwhile, external wrapping with a 1-cm-wide polyester-urethane vascular patch was performed to strengthen the vein wall in the venospasm condition. Results: Symptoms were immediately relieved postoperatively. Refractory ulcers healed five months after the procedure. At the six-month follow-up, color duplex ultrasound of the deep vein of the left lower limb showed no reflux in the proximal segment of the femoral vein. Conclusion: Internal valvuloplasty combined with sleeve wrapping is feasible in the treatment of severe deep venous incompetence with good short-term results.