[Post-phlebothrombotic venous insufficiency of the lower limbs. Echo-guided targetted surgery]

The post-phlebothrombotic syndrome surgery has always had a limited space within the limits of the venous lower limbs surgery. This, either for the distrust of surgeon to operate a limb with deep thrombotic phenomenon, or because the range of possible operations is rather limited and constituted by very cruent and devasting operations. The introduction of very accurate method in the preoperative diagnostic, as the echo-color-Doppler, enables an accurate mapping of the new venous post-phlebothrombotic situation and a careful haemodynamic study of the deep or superficial venous circle. Hence, the surgeon has a new and significant chance to perform a minimal surgery generally directed to the ligation of the perforans veins that has become incontinent after the phlebothrombotic insult. In this way, the wide and devasting dissection can be avoided as previous Linton-type interventions.