Surgical management of deep venous reflux

Axial deep venous reflux can be found in the majority of extremities with advanced skin changes and ulceration. It frequently is associated with recurrent disease and tends to progress with time. More than 30 years' experience with deep venous reconstructive surgery, as well as recent advances in diagnostic imaging, makes possible the rational use of such techniques in the management of chronic venous insufficiency. This report reviews the role of deep venous reflux in the natural history and progression of venous disease, the options for surgical correction of deep venous reflux, the current diagnostic abilities and limitations, and the results of surgical interventions.