Hemodynamic results of femoral vein valve repair.

Our aim was to assess the hemodynamic and clinical responses associated with valve repair surgery in 37 patients with severe chronic venous insufficiency. Patients classified as C(4-6)E(P)A(SDP)P(R) (primary venous dysfunction with skin changes with reflux of superficial, deep and perforating veins) were submitted to a novel procedure combining the closed technique described by Kistner with the Dacron sleeve technique described by Hallberg (mean follow-up = 24 months). A significant improvement in Valsalva test results (P < 0.0001), ambulatory pressure (P = 0.0099), venous refilling time (P < 0.0001), and reflux index (P < 0.0001) was observed. Postoperative reactive hyperemia and gradient tests confirmed absence of venous obstruction signs. On their last visit, 85.3% of the patients had no ulceration, and edema was absent or minimal in over 90%. About 70% of the patients referred partial or complete relief of pain in the affected limb. The combined surgical technique was effective to control venous reflux 24 months after the procedure. A longer follow-up would be necessary to assess long-term results.