[Anti-reflux surgery of the popliteal vein]

Any effective therapy of chronic vein insufficiency resides in the replacement or at least reduction of the pathological reflux causing venous hypertension. The aim of our study is to indicate the significance of the reconstruction of the damaged valves in the profound venous system, namely in the most critical popliteal area. On the basis of the experimental works of Wilson et al. (1991) we have introduced his technique of anti-reflux operation by the technique of invagination after the prolongation of the popliteal vein by three-fold average of its diameter by means of the axillary vein with a valve. This operation was performed in 6 patients on 7 veins. The operation lasted 3 hours in average without marked operative and post-operative complications. On the seventh day after operation, the full sufficiency is investigated by means of descendent phlebography in 5 newly formed valves and in two valves a particular insufficiency is developed. 4 patients yield a full recovery of ulcers, one patient slipped out from evidence, however sclerotisation of insufficient perforators leads quickly to recovery of dermal defects. Reconstruction of prothrombotically damaged valves is practically impossible and thus, valvuloplastic operation constructed from vascular wall in the target segment is not only possible but effective at the same time. (Fig. 3, Ref. 13.)