Surgical treatment of post-phlebitic syndrome

The post-phlebitic syndrome which succeeds deep vein thrombophlebitis may be treated by various surgical interventions. Removal of incompetent perforating veins and excision of any concomitant skin ulcer with grafting is a usual course of therapy. However, if the skin ulceration and symptoms are actually due to deep venous incompetence then a more direct approach should be attempted. Numerous procedures have been advocated, such as valvoplasty, homologous vein transplant, synthetic valve procedures and autogenous vein valve transplant. It has been demonstrated that autogenous vein valve transplant yields a satisfactory haemodynamically stable result with high valve competency rates. The authors have operated on 10 patients utilizing an autogenous vein valve with good results. Pre- and postoperative data including ascending and descending venography indicate that valvular competence is restored and ulcers heal.