The efficacy of external valvuloplasty with silicone stents (Venocuff™) in the management of focal valvular incompetence as assessed by Doppler ultrasound

Özet

Objectives: This study aims to assess the efficacy of external valvuloplasty with silicone stents in the management of isolated terminal orpreterminal valve dysfunction at the saphenofemoral junction based on comparisons between pre- and postoperative findings on Dopplerultrasound of the lower limbs.Patients and methods: This study included a total of 16 female patients (mean age 44.1±7.6 years; range, 32 to 58 years) who underwentvalvuloplasty with the Dacron®-reinforced silicone cuff (Venocuff II™ Venous Valve Exostent) for the treatment of focal superficialvenous insufficiency between April 2014 and September 2018. Postoperative color Doppler ultrasonography (CDUS) findings at three tosix months were retrospectively compared to preoperative CDUS findings to analyze the efficacy of the surgical technique. Preoperativemeasurements of the diameter (in mm) of the great saphenous vein and reflux time at the saphenofemoral junction were compared topostoperative measurements. Valvular incompetence was graded 0 to 4 based on the reflux time. All assessments were performed with a7.5 MHz superficial vascular probe on an CDUS scanner. Clinical improvement was assessed based on the revised Venous Clinical SeverityScore (VCSS).Results: The grade of great saphenous vein reflux was significantly lower after surgery compared to the reflux grade measured beforesurgery. A statistically significant decrease was detected in the mean diameter of the great saphenous vein (p<0.05), and the VCSS decreasedstatistically significantly after surgery.Conclusion: The Venocuff™ procedure is an effective surgical option which can reduce future complications by alleviating venousinsufficiency. Moreover, patients may feel more comfortable with the procedure compared to other surgical modalities. Venous CDUS isof paramount importance for the diagnosis of isolated venous valvular insufficiency, as well as for the follow-up of patients after surgery.