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Jack B. Huse, MD; Donald C. Nabseth, MD; Harry L. Bush, Jr, MD; Warren C. Widrich, MD; Willard C. Johnson, MD

Arch Surg. 1983;118(6):719-723.

Abstract
• Seven patients had severe deep venous insufficiency and recurrent ulceration in eight lower extremities. All incompetent perforating veins had been previously ligated. All limbs were evaluated by dynamic venous pressure measurements. The venous pressure reduction with exercise was recorded, as well as the recovery time. The most accurate indicator of venous valvular incompetence was a short postexercise recovery time. Abnormal hemodynamic findings were correlated with ascending and descending venographic findings. Based on these anatomic and pathophysiologic abnormalities, patients underwent valvular transposition, superficial femoral vein valvuloplasty, or superficial femoral vein ligation, Immediate postoperative recovery time (mean±SEM) was improved to 34.5±18.3 s from 7.9±2.9 s preoperatively. Postoperative venography demonstrated patency of all anastomoses and absence of reflux into previously incompetent venous systems. All limbs were symptomatically improved after operation, and no venous thrombosis or pulmonary emboli developed. Persistent ulceration, however, continued in one limb.

(Arch Surg 1983;118:719-723)

Author Affiliations
From the Departments of Surgery (Drs Huse, Nabseth, Bush, and Johnson) and Radiology (Dr Widrich), Boston Veterans Administration Medical Center.

Footnotes
Accepted for publication Aug 10, 1982.

Read before the annual meeting of the New England Society for Vascular Surgery, Waterville Valley, NH, Sept 24, 1981.

Reprint requests to 116 Cook Ave, Meriden, CT 06450 (Dr Huse).

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