superficial femoral vein valve repair

Due to congenital valvular dysplasia and long-term standing or weight-bearing, blood column gravity from the proximal iliac vein acts on the valves of the saphenous vein, superficial femoral vein, and deep femoral vein. Due to anatomical factors, the great saphenous vein valve can be affected alone or first, and the superficial femoral vein valve is the second, while the deep femoral venous valve is least affected. Therefore, for patients with moderate or severe deep venous insufficiency, in addition to high ligation, exfoliation and traffic branching of the great saphenous vein, the corresponding surgical procedures such as venous valve repair, valved vein graft, femoral vein should also be used. Valvular band or venous wall annuloplasty, semitendinosus and biceps femoral venous valve replacement (referred to as tendon valvular surgery). The valve that is stretched, prolapsed, and closed is shortened and repaired to a semi-straight state by surgery, so that it can be closed and closed to prevent blood from flowing backward. Treatment of diseases: primary deep venous valve insufficiency Indication 1. No history of deep vein thrombosis. 2. After antegrade angiography, the deep vein is patency, enlargement, and straight tubular. Inverse angiography showed moderate or severe reflux. 3. During the operation, the femoral vein is thicker, but the contour, color and elasticity are normal, and there is no trace of inflammatory reaction. When testing the flow of blood, it can be seen that the proximal blood flows back across the valve to the distal side. Cut the wall of the tube and see that the free edge of the valve is slack and sagging. Contraindications Preoperative preparation Surgical procedure 1. The occlusion-femoral vein was exposed to the medial side of the femoral artery of the thigh of the affected limb. The upper end slightly exceeded the groin plane and was about 12 cm long. The junction of the saphenous-femoral vein was found along the main saphenous vein trunk, revealing the common femoral vein, superficial femoral vein and deep femoral vein. A pair of valves with the highest femoral vein can be seen distal to the junction of the superficial femoral vein and the deep femoral vein. 2. Detecting the superficial femoral vein of the superficial venous valve function, slightly bulging, blocking the superficial femoral vein blood flow 5 cm distal to the valve, and simultaneously blocking the deep venous blood flow, which will block the proximal side of the valve. The blood is squeezed into the total femoral vein to make it empty. If the squeezed finger is released, the blood is immediately turned back through the valve, confirming that the valve is incomplete. 3. Repair the valve to block the common femoral vein, deep femoral vein and the distal femoral venous blood flow. In the superficial femoral vein, the first pair of valves are longitudinally cut in the center of the cup-shaped shape on the wall. The incision is about 1.5 to 2.5 cm long. After the resection of the margin, a valve with a free edge and a sagging elongation can be seen. The valve is flushed with heparin-containing saline to make the lesion of the valve clearer. Use 7-0 non-invasive suture at the intersection of the two valves from the outward to the inner needle, 2mm from the intersection point through the free edge of the two valves, and then the needle from the inside out at the plane of the intersection point, tighten the suture, outside the wall Knotted, the free edge can be shortened by 2 mm, and sutured at the other side of the valve intersection in the same way [Fig. 1]. If the needle is not enough, the second needle can be sutured at a slightly higher or a little distance from the free point to further shorten the valve. After the repair is completed, rinse with heparin saline, and the free edge of the valve is semi-straight. The wall incision was sutured and the blood was again tested for backflow, confirming that the valve repair was satisfactory. Open the veins to stop the blood flow. After strict hemostasis, a drainage tube was placed in the incision, and the incision was sutured layer by layer. complication infection.

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