ABSTRACT
The vein valve transplantation has, in our experience, subjectively relieved symptoms in the majority of patients. More importantly, elevated venous pressure has been decreased in most patients. Thus, patients exhibiting signs of venous insufficiency syndrome as well as elevated venous pressure and proved valvular incompetence should be considered candidates for vein valve transplantation after an unsuccessful trial of medical management.
Subject(s)
Leg/blood supply , Microsurgery/methods , Veins/transplantation , Venous Insufficiency/surgery , Follow-Up Studies , Humans , Phlebography , Postoperative Complications/etiology , Veins/surgery , Venous Insufficiency/physiopathology , Venous PressureABSTRACT
We have found that the venous pressure slope during minimal exercise is a sensitive measurement of venous disease. This parameter differed greatly in our two study populations. Due to increased venous pressure, venous insufficiency syndrome patients have a greater volume of pooled blood, which results in smaller pressure changes with each muscle contraction. In patients with incompetent valves, blood flows in a retrograde fashion in the vein, which leads to a higher steady state minimal pressure and notably to a decreased venous pressure slope. Venous pressure slope is a particularly sensitive measurement and a good prognosticator of venous insufficiency syndrome before symptoms become disabling to the patient. Our data indicate a strong correlation between venous pressure slope and venographic results. In fact, patients with abnormal venographic results invariably have demonstrated venous pressure slopes in the abnormal range.
Subject(s)
Blood Pressure Determination/methods , Leg/blood supply , Venous Insufficiency/physiopathology , Venous Pressure , Ambulatory Care , Exercise Test , Humans , Monitoring, Physiologic/methods , Phlebography , PostureABSTRACT
The vein valve transplant has, in our experience, subjectively relieved symptoms in the majority of patients. More importantly, elevated venous pressure has been decreased in most patients. Thus, patients exhibiting signs of venous insufficiency syndrome as well as elevated venous pressure and proven valvular incompetence should be considered candidates for vein valve transplants after an unsuccessful trial of medical management.