Angioscopy-assisted valvuloplasty for primary deep venous valvular insufficiency

Area of Science:

• Vascular Surgery
• Minimally Invasive Procedures
• Venous Disease Management

Background:

• Deep venous valvular insufficiency is a primary cause of reflux syndrome.
• Current treatments may not always preserve valve integrity.
• Visual control during valvuloplasty is crucial for optimal outcomes.

Purpose of the Study:

• To evaluate the efficacy and safety of angioscopy-assisted venous valvuloplasty.
• To assess the impact of this technique on venous reflux and patient outcomes.
• To compare angioscopy-assisted valvuloplasty with traditional surgical approaches.

Main Methods:

• Four patients (3 men, 1 woman) with Class 3 venous disease underwent angioscopy-assisted valvuloplasty of the superficial femoral vein.
• Procedures included PTFE graft wrapping, superficial vein stripping, and perforating vein ligation.
• Follow-up included clinical assessment, duplex ultrasonography, descending phlebography, and ambulatory venous pressure measurements.

Main Results:

• All patients showed significant improvement in ambulatory venous pressure and normalized venous filling time.
• Ulcers healed in three patients, with near-complete healing in the fourth after skin grafting.
• Post-procedure imaging confirmed no residual reflux, and repaired valves remained patent and competent at a mean 12-month follow-up.

Conclusions:

• Angioscopy-assisted venous valvuloplasty offers a precise and simple method for treating deep venous reflux.
• This technique combines the accuracy of phlebotomy-based valvuloplasty with the simplicity of external valvuloplasty.
• It represents a preferred approach over existing methods for managing severe venous insufficiency.