Surgical treatment of profunda femoral vein insufficiency

Abstract

To study the role and curative effect of encircling construction of the popliteal vein and ligation of the profunda femoral vein (PFV) to treat profunda femoral vein insufficiency (PFVI). Thirty-four patients were diagnosed as having PFVI through phlebography and color ultrasound system. (CEAP clinical scale: C(4) 31, C(5) 1, C(6) 2). The forms of the profunda femoral veins (PFV) were Raju grouping, type II: 22, type III: 10, type IV: 2. Thirty-two patients' popliteal veins were annularly constructed in the distal communication of the PFV and the popliteal vein, and in the abouchement of gastrocnemius vein into the popliteal vein. The other two PFV trunks were ligated at the communication of PFV trunk and the popliteal vein. Thirty-one patients (91.1%), 4, 6-year follow-up in average, threw off their aching pain in the leg. Pigmentation from the ankle to the middle of the leg subsided; the ulcers were healed and did not relapse. The postoperative ambulatory venous pressure detected was distinguishable from the preoperative data (P < 0.01), venous pressure recovery time > 22 seconds. A standing position (60 degrees from the vertical) is used in the postoperative phlebography. And the development time of the contrast media reaching the superior margin of patellar level, together with the regurgitation volume per minute of the popliteal vein detected through color ultrasound system in a standing position, was recorded. The patients' physical status had been greatly improved after the surgery (P < 0.01). The back flow caused by PFVI has a deep impact on the hemodynamics of the lower limb. In the popliteal fossa, it is operable and effective to use encircling construction of popliteal vein and the ligation of the PFV to treat PFVI.