Overview of potential benefits of direct venous reconstruction

As methods of direct venous reconstruction have been developed, it has been necessary to define which patients should receive these operations and which procedures are clinically acceptable or frankly experimental. The patient who needs venous reconstruction is one who is prevented by his venous stasis disease from gainful employment and/or a comfortable life. Such patients, in general, should receive conventional ablative venous surgery but, in fact, some reconstructive techniques are less traumatic and less morbid. At this time, the technique of venous valve reconstruction by valvoplasty is a standardized procedure which appears to have durable results. Autogenous venous bypasses, as proposed by Palma, to bypass iliac venous occlusion and superficial femoral venous occlusion also appear to have acceptable long-term patency rates. Among the experimental procedures becoming available are prosthetic replacement of major veins and maintenance of patency of such grafts by complementary arteriovenous fistulas.