How to treat great saphenous vein insufficiency?

Veins are the most important part of the blood circulation system. They have a great impact on the health of the body. Once threatened by disease, major changes will occur. Among them, great saphenous vein insufficiency is one of the common problems. It is also quite rare. It is also difficult to treat and difficult to recover completely. Let’s take a look at how to treat great saphenous vein insufficiency.

Surgery for primary valvular insufficiency of the deep veins of the lower limbs is performed because the gravity of the blood column from the proximal iliac femoral vein acts on the valves of the great saphenous vein, superficial femoral vein and deep femoral vein due to congenital malformed valve structure and long-term standing or weight-bearing. Due to anatomical reasons, complete surgery is not possible.

Due to anatomical factors, the great saphenous vein valve may be affected alone or first, followed by the superficial femoral vein valve, and the deep femoral vein valve is least affected. Therefore, for patients with moderate or severe deep venous valvular insufficiency, in addition to high ligation, stripping and ligation of the great saphenous vein and its perforating branches, corresponding surgical procedures should also be used, such as venous valve repair, valved vein segment transplantation, femoral vein valve banding or femoral vein wall ring suture, semitendinosus-biceps femoris loop popliteal vein valve replacement (abbreviated as muscle loop valve replacement), etc.

Surgical procedures

1. Expose the common femoral vein, superficial femoral vein and deep femoral vein according to the above method, and confirm the insufficiency of the highest pair of valves in the superficial femoral vein through testing.

2. Preparation of the transplanted vein segment: If it is taken from the healthy side superficial femoral vein, expose the healthy side superficial femoral vein according to the previous method. After confirming that the valve function is good, cut vein segments of equal length from both sides of the superficial femoral vein (including the second pair of valves) and exchange and anastomose them. If it is taken from the axillary vein, a straight incision can be made in the armpit to expose the axillary vein. After determining that the valve function is good, a 2 cm long vein segment containing the valve can be cut. If the axillary vein is single-branched, a 3-cm long section of great saphenous vein from the affected limb is exchanged for it. If there is still branch reflux, after removing the transplanted segment, the distal and proximal ends can be ligated.

3. Anastomosis of the transplanted vein segment: Cut the superficial femoral vein 1 cm distal to the highest pair of valves, then place the transplanted vein segment between the gaps formed by the elastic retraction of the two ends of the superficial femoral vein, and anastomose the two opposite ends with 7-0 non-damaging sutures. Strictly stop bleeding, place a drainage tube, and suture the incision layer by layer.

Postoperative treatment: Same as venous valve repair.