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 PS136. Effect of Pregnancy on Exostent Venous Valve Repair at the Sapheno Femoral Junction (SFJ)

​Martijn L. Dijkstra2, Rodney J. Lane1, Walid Mohabbat3
1Vascular Surgery, Royal North Shore Hospital, Sydney, NSW, Australia; 2Dalcross Private Hospital, Sydney, NSW, Australia; 3Macquarie University Private Hospital, Sydney, NSW, Australia.

OBJECTIVES: Pregnancy is a major contributory factor in the increased incidence of varicose veins in women, which in the long term can lead to venous insufficiency and leg edema. Traditionally treatment is aimed at symptom reduction and is divided in three groups: surgery, pharmacological and non-pharmacological treatments. Advantages in treatment of venous incompetence has been achieved by exostent venous valve repair. The aim of this paper is to assess the effect of pregnancy on exostent venous valve repair at the SFJ, either with or without the subterminal valve.

METHODS: A total of 31 limbs subjected to 29 pregnancy (including twins) have been investigated using ultrasonography with assessment of the valve and valve mobility, the cusps and whether there was incompetence. These where subsequently treated and followed up for a minimum of 2.3 years (mean 8.3, ±3.8) in 18 women (mean age at time of surgery 34, ±9), both clinically and ultrasonically. Recurrences and additional venous treatments where noted.

RESULTS: The Australian National Medical database indicates 3,262 patients have had SFJ valve (with or without the subterminal valve) repaired using exostents for varicose veins. Recurrences have occurred in 5 (16%) of the 31 limbs in the valve stented limb. These were treated with ultrasound guided sclerotherapy. Recurrent SFJ incompetence was encountered in 4 (13%) patients. None have required surgical intervention. Two of the four limbs with incompetence of other venous systems treated with venous ablation sustained recurrences.

CONCLUSIONS: Exostent venous valve repair at the SFJ can withstand the hemodynamic stresses of a pregnancy.

AUTHOR DISCLOSURES: M. L. Dijkstra, Nothing to disclose; R. J. Lane, Allvascular Pty. Ltd., Ownership or Partnership; W. Mohabbat, Nothing to disclose.

Posted April 2012

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