An Overview on Venous Valvuloplasty and Saphenous Sparing

Abstract

Venous valvuloplasty (VV) has been proposed for over 50 years to obtain functional reconstruction in patients with chronic venous insufficiency. The various techniques used have given long-term positive results in about 80% of the cases treated, which is moderately better than ablative techniques for the same pathologies. VV seems to be advisable in cases of poor compliance of the deep venous system following ablation of the great saphenous vein. Furthermore, it allows the saving of the saphenous conduit, which represents a precious advantage in case of need for arterial replacement surgery. So far it did not get widespread. Reasons for this include: rather strict eligibility criteria, which reduce the number of possible beneficiaries; the greater complexity of the procedure, both diagnostic and operative, compared to the endovascular ablative techniques proposed in recent decades; the scarce availability of adequate medical devices. Current research seems oriented towards the development of prosthetic neo-valves, made of biomaterials engineered with innovative techniques, which can be positioned by catheter in the deep venous system.