Direct popliteal valve substitution by Technique II and its efficacy in deep venous insufficiency of the lower limb

The substitute "valve" operation by Technique II using a silastic tendon designed to produce a valve-like mechanism on the popliteal vein is described. The results achieved in 65 limbs with deep venous insufficiency due to reflux in the deep veins have been assessed by Doppler ultrasound, by measurement of ambulatory venous pressure before and one week after operation and by phlebography twenty seven limbs were followed-up one to three years after operation. The clinical improvement in 60 limbs was associated with reduction in the ambulatory venous pressure, with abolition of popliteal reflux and phlebographic evidence of a functioning substitute "valve".