Femoral vein valve repair with limited anterior plication (LAP)

Abstract

Limited anterior plication (LAP) of the incompetent femoral vein was used in 2 groups of subjects with venous hypertension due to deep and superficial venous incompetence. Group 1 subjects were treated only with superficial veins surgery while groups 2 was treated with external valvuloplasty (LAP) at the level of the incompetent femoral vein. The plication was performed at the anterior side of the vein after limited dissection and manipulation. During a two-year follow-up the results of LAP were evaluated with color-duplex and ambulatory venous pressure (AVP) measurements. Nine of the 11 femoral veins treated with LAP were competent after 2 years (in 2 the incompetence was reduced). A lower AVP and RT was found in subjects treated with LAP in comparison with those in Group 1. Also the number of recurrent varicose veins (incompetent venous sites) and the average diameter of the femoral vein were higher in Group 2 (superficial surgery only). As no complications were observed LAP can be considered an alternative to the standard external valvuloplasty in cases of moderate incompetence when valve cusps are present and functional and incompetence is mainly due to relative enlargement of the vein diameter.