[External valvuloplasty under preoperative angioscopic control]

Intraoperative angioscopy was applied to evaluate the venous valvular incompetence and perform external valvuloplasty in case of venous reflux. Sixty-seven limbs, 43 cases of primary varicose veins were examined using intraoperative angioscopy and the angioscopic findings of the incompetent venous valves were classified into three types as follows: valves with elongated and atrophic cusps 43 (50%)--type I, values with expanded and depressed commissures 36 (42%)--type II, and valves with perforated cusps or other changes 7 (8%)--type III, according to the angioscopie findings, external valvuloplasty was done in 31 subterminal valves of the long saphenous veins and 7 highest valves of the superficial femoral vein. Our external valvuloplasty consisted of two techniques. The first was the total plication technique for valvular annulus by a running suture of prolene and the second was by the venocuff sleeve of the autogenetic femorofascial band. The degree of plication was decided by angioscopic observation. Postoperative observation periods were from 2 to 28 months. There was no recurrence of varicose veins or prominent venous reflux. The application of intraoperative angioscopy is therefore useful for the choosing appropriate surgical procedures and for the evaluation of venous valvuloplasty.