Deep venous external valvuloplasty using a rigid angioscope.

PURPOSE: The aim of this study was to evaluate the long-term results of deep venous valvuloplasty using a rigid metal angioscope.
METHODS: Forty patients who underwent deep venous external valvuloplasty using a rigid metal angioscope for primary deep venous insufficiency were enrolled. The preoperative CEAP (Clinical/Etiology/Anatomy/Pathophysiology) classifications were class 2 in 13 patients, class 3 in 8 patients, class 4 in 12 patients, class 5 in 1 patient, and class 6 in 6 patients. In 9 legs in 6 patients, the valves were either destroyed or congenitally absent, and deep venous plication was applied instead. The long-term operative results were evaluated from clinical charts and direct telephone interviews.
RESULTS: During a mean follow-up period of 5.0 years, we experienced no deep vein thromboses or other complications. In 39 of the 40 patients, the subjective symptoms improved. The improvement after successful valvuloplasty was 82% with respect to the CEAP classification. Among the 9 legs treated by deep venous plication alone, 5 had improved CEAP classifications, while 4 showed no change.
CONCLUSIONS: Deep venous external valvuloplasty assisted by a rigid angioscope is a safe and effective method for severe valve insufficiency. Furthermore, the long-term results are positive. Deep venous plication may therefore represent an effective alternative for patients who cannot undergo valvuloplasty.