The Diagnosis And Treatment Of Primary Deep Venous Insufficiency

Objective To summerize the clinical experience of different methods in the diagnosis and treatment of primary deep venous valve insufficiency (PDVI)and evaluate the therapeutic effect of the superficial—inferior femoral vein bypass procedure in the treatment of primary deep venous insufficiency .Methods In this study ,thirty-one lower extremities in thirty patients, who were diagnosed to be severe PDVI(angiography showed that reflux degree was 3-4 grade )by ascending venography and Duplex scanning were studied. All lower extremities were treated with procedure of the superficial—inferior femoral vein bypass .And they were also treated with the high ligation of great saphenous vein, superficial veins and ligation of perforator veins at the same time. Clinical scoring were followed up from eight months to forty-eight months after operation to evaluate the effect of the operation. Results The curative results were satisfactory. The difference between preoperative and postoperative were remarkable, the average ambulatory venous pressure after operation was 102.7 ± 6.5cmH2O, were significantly different from that before operation(148.7 ± 8.8cmH2O) (P<0.01). The symptoms disappear and ulcers were healed in all the patients. The Doppler ultrasonogmphy showed that blood cannot distinct flow backwards in the vein. Conclusion The treatment of thesuperficial—inferior femoral vein bypass is an effective method in treatment of severe primary deep venous and have the value of widespread application, but it should be based on degree of deep venous insufficiency. The venous augiography is important basis of determining operative type.