Haemodynamic Management of Deep Venous Insufficiency

Deep veins can be affected of reflux as well as the superficial ones, mostly after a deep vein thrombosis with alteration of the valves. In a third of the patients, a segmental duplication is found in the deep veins at the thigh. In case the deep vein reflux affects only one of the duplicated vessels, a selective interruption of the other can clearly improve the haemodynamic situation. At the calf, where several deep veins are present, a selective interruption of one of the deep vein trunks at the popliteal vein can solve recirculations involving secondary superficial varices. The rationale, practical approach and decisions are explained in the chapter.