Applied Anatomy And Clinical Signicance Of The Chief Venous Valve In The Lower Extremity

PART I APPLIED ANATOMY OF THE CHIEF VENOUS VALVE IN THE LOWER EXTREMITYObjective:Anatomic observation of the chief venous valve in the lower extremity was performed on 150 sides of adult cadavers to provide anatomic reference about the venous operation of the lower extremity.Method:On 150 sides of adult cadavers , the following indexes are observed and measured: the quantity and shape of the venous valve of great saphenous vein, femoral vein and popliteal vein;the external diameter at some special points and position relation of some important adjacent structure. Furthermore, these data are aggregate analyzed.Results:The quantity of the venous valve of great saphenous vein is 4 to 15,and the average is 7.2;The quantity of the venous valve of femoral vein is 1 to 6,most of them have 3 or 4 venous valves,the mean quantity is 3.3. The quantity of the venous valve of popliteal vein is 0 to 5,most of them have 1 or 2 venous valves,and 3 sides have no venous valve. The mean quantity of the popliteal venous valve is 1.8. The position of the first valve of superficial femoral vein is constant fairly. The distance from sapheno-femoral junction is (5.45±1.32)cm. Most of these valves consist of double cusp leaflets, and there is much more valves in the distal veins.Conclusions:Data of this study based on applied anatomy are provided systematic and detailed basis to those operations in the lower extremity.PART II ANALYSIS ON SURGICAL TREATMENT OF PRIMARY DEEP VENOUS VALVE INSUFFICIENCY IN LOWER EXTREMITYObjective:To study and evaluate the theraputic effects of three frequent deep venous valve reconstruction for primary deep vein valve insufficiency(PDVI)in lower extremity.Method:From July 2005 to December 2007,28 patients(36 limbs) diagnosed to be primary lower extremity deep vein valve insufficiency by ascending and retrogressing phlebography were treated with high ligation and stripping of great saphenous vein,indirect loop valvuloplasty,internal valve suture repair and transplantation of valve-bearing vein segment. Compare color Doppler ultrasonography,the CEAP classification and clinical scores of pre-operation and postoperation to evaluate the effects of these operations. Some data was analysis by statisticsResults:The CEAP classification and clinical scores of all patients were decreased. The preoperative and postoperative scores is(6.2±3.1),(2.1±1.5)respectively,the difference between them were remarkable (P < 0.01). The preoperative and postoperative scores of sixty-five limbs which classified with C2 and C3 before operation is(2.2±1.1),(1.1±0.7),the difference also significant(P < 0.05).Conclusions:Indirect loop valvuloplasty,internal valve suture repair and transplantation of valve-bearing vein segment are effective way to correct the primary deep venous valvular incompetence of the lower limb.Those patients whose clinical scale is two or three grade could be treated merely with high ligation and stripping of great saphenous vein...