Chronic venous insufficiency disease. Its etiology. A new technique for vein valve transplantation.

This is a two-year study of 25 patients with venous insufficiency who were found to be in the terminal stage, referred to in this paper as chronic venous insufficiency disease (CVID). Apart from the usual signs and symptoms of venous insufficiency, the patients were found to have severe pain on weight bearing, inability to ambulate, and nonhealing lower extremity ulcers as common features that did not respond to conservative management. The most common underlying etiology was valvular incompetency. In the surgical management of these patients, at present, all the procedures described in the literature are primarily performed in the femoral veins of the groin or above the knee. A new technique is described in this paper that enables one to transplant vein valve segments to distal popliteal vein below the knee. There was a six- to twenty-four-month follow-up. Patients were periodically followed up with venography, venous pressure measurements, and venous reflux studies.