Vein Valve Graft for Primary Femorosaphenous Incompetence

Primary femorosaphenous incompetence (FSI) is a rare cause of venous stasis and ulceration and is conventionally managed by ligation of the saphenofemoral junction with or without stripping of the long saphenous vein (LSV).The authors present here 9 patients with FSI documented by phlebography who were managed by the alternate procedure of vein valve graft from the basilic vein to the long saphenous system to restore competency of the femorosaphenous (FS) junction . This procedure has hitherto not been tried for primary varicosity of the LSV.There was cosmetic improvement in all patients. Chronic ulcers in 5 patients seen preoperatively remained healed during a follow-up period of one to five years. There was symptomatic improvement of heaviness of the limb in 5 of 6 patients . Phlebography at one year postoperatively showed competency of the FS junction in all 9 patients and graft patency in 8 of 9 patients.This procedure has the added advantage of preserving the LSV for future use in arterial bypass sur...