[Classical surgical experience in postphlebitic disease]

Besides the current methods of shunting and the restoration of the valve system, the surgery of venous deficiency remains important in other ways too. The superficial venous system plays a supply rôle at the stage of acute thrombosis but, once it has become dilated, it becomes deficient and so becomes the location for orthostatic reflux; in post-phlebitic illness, this superficial deficiency is often further complicated by a deficiency of the tibial communicating veins, the pathogenic implication of which is significant. Correction of these haemodynamic disorders by classic methods may be effected either in isolation or in association with an operation aimed at the obstructive syndrome or the syndrome of deep reflux; particular attention must be paid to the problem of the tibial communicating veins. Surgical indications are definitively based on a precise physiopathological report on the post-phlebitic syndrome causing the problem.