Description:
Chronic deep venous incompetence causes a range of symptoms and signs in the legs, including pain, swelling, skin changes (lipodermatosclerosis) and recurrent ulcers. The condition may be caused by incompetence of the valves in the deep veins (when valves do not close properly, allowing blood to reflux back down the veins), by obstruction of vein lumen (for example after deep vein thrombosis or trauma to the vein), or a combination of the two.
Deep venous valve reconstruction is usually performed under general anaesthesia. A number of techniques exist for reconstructing the venous valves, the most common of which is valvuloplasty (internal or external). The appropriate segment of vein is accessed through an incision in the leg and dissected free from surrounding tissue. Internal valvuloplasty involves tightening the valve cusps by stitches.
External valvuloplasty involves suturing a fold into the external vein wall to reduce the diameter of the vein and allow the valve cusps within to meet properly. A variation of this technique is limited anterior plication, which is carried out only on the anterior side of the vein after limited dissection of the anterior circumference of the vein.
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