Invited commentary

Abstract

The treatment of chronic venous insufficiency attributed to deep valvular incompetence has been limited because of challenges in correcting the anatomic and physiologic derangements in the lower limb. Our specialty has attempted deep vein valvuloplasty, valvulopexy, valve transposition, vein bypass grafts, and various deep vein endoluminal therapies. Failure modes have primarily been attributed to thrombotic complications, which may worsen the patient's symptoms. None of these therapies have demonstrated reversal of venous hypertension or improvement in venous wound healing. The current article examines a novel therapy, popliteal vein external banding, during a 15-year period. The authors present a robust cohort, 1252 patients, managed with this technique, and their results are better than in any previous report to date. They should be applauded for their ulcer healing rates and wound recurrence rates of only 3.6%. In addition, they experienced a relatively low rate of venous thrombotic complications as a result of popliteal venous banding. This technique is the first intervention that has demonstrated promising results for deep venous insufficiency. I look forward to other centers examining this technique, validating their results, and potentially improving therapies for deep venous insufficiency. Popliteal vein external banding at the valve-free segment to treat severe chronic venous insufficiencyJournal of Vascular SurgeryVol. 64Issue 2PreviewAxial deep venous reflux causes skin changes or ulcers in patients with chronic venous insufficiency (CVI). The study aimed to review the results of correcting axial deep venous reflux using the novel valve-free popliteal vein external banding (PVEB) technique in patients with severe CVI. Full-Text PDF Open Archive