External Valvuloplasty of the Sapheno-Femoral Junction

  • Paolo ZamboniEmail author
  • Sergio Gianesini


The optimal treatment of any illness is the restoration of the normal function. If the function of all the venous valves could be restored, the problem with superficial venous insufficiency was solved. In some situations and selected patients, an answer has been found in the form of the external valvuloplasty of the proximal valves in the great saphenous vein. The sapheno-femoral junction is coated with a soft non-absorbable material (PTFE) so to reduce the calibre and achieve again the closing of the terminal and preterminal valves. About 95% of competent saphenous valves in the follow-up, consequently finding an orthograde, restored flow in the saphenous vein, a calibre reduction, as well as clinical restoration of the symptoms. Further investigation on materials and techniques is going on in this very promising field of venous surgery.


  1. 1.
    Edwards JE, Edwards EA. The saphenous valves in varicose veins. Am Heart J. 1940;19:338–51.CrossRefGoogle Scholar
  2. 2.
    Bassi GL. Le varici degli arti inferiori. Turin: Minerva Medica; 1962.Google Scholar
  3. 3.
    Rose SS, Ahmed A. Some thoughts on the etiology of varicose veins. J Cardiovasc Surg. 1986;27:534–43.Google Scholar
  4. 4.
    Somjen GM, Donlan J, Hurse J, Bartholomew J, Johnston AH, RoyIe P. Venous reflux at the sapheno-femoral junction. Phlebology. 1995;(4):132–5.CrossRefGoogle Scholar
  5. 5.
    Van Bemmelen PS, Summer DS. Laboratory evaluation of varicose veins. In: Bergan JJ, Goldman MP, editors. Varicose veins duplex examination of the sapheno-femoral junction and telangiectasias, diagnosis and treatment. St. Louis, MO: Quality Medical Publishing; 1993. p. 73–84.Google Scholar
  6. 6.
    Zamboni P, Gianesini S, Menegatti E, Tacconi G, Palazzo A, Liboni A. Great saphenous varicose vein surgery without saphenofemoral junction disconnection. Br J Surg. 2010;97(6):820–5.CrossRefGoogle Scholar
  7. 7.
    Camilli S, Guarnera G. L' insufficienza venosa primaria e le possibilità della chirurgia ricostruttiva. Padova: Piccin; 1993.Google Scholar
  8. 8.
    Hallberg DA. A method for repairing incompetent valves in deep veins. Acta Chir Scand. 1972;138:143–5.PubMedGoogle Scholar
  9. 9.
    Corcos L, Peruzzi GP, Romeo V, Procacci T, Zamboni P, Dini S. Valvuloplastia de la union safeno-femoral. Video-revista de cirugia. 1992;9:17–30.Google Scholar
  10. 10.
    Corcos L, Zamboni P, Liboni A. External valvuloplasty of the s-f junction in early varicose veins of the lower limbs. In: Davy A, Stemmer R, editors. Phlebologie-Phlebology, vol. 89. Paris: Libbey; 1989. p. 1025–7.Google Scholar
  11. 11.
    Lane RJ, McMahon C, Cuzzilla M. The treatment of varicose veins using the venous valve cuff. Phlebology. 1994;9:136–45.CrossRefGoogle Scholar
  12. 12.
    Schanzer H, Skladany M, Peirce ECIII. The role of external valvuloplasty in the surgical management of chronic deep venous disease. Phlebology. 1994;9:8–12.CrossRefGoogle Scholar
  13. 13.
    Zamboni P, Marcellino MG, Cappelli M, Feo CV, Bresadola V, Vasquez G, Liboni A. Saphenous vein sparing surgery: principles, techniques and results. J Cardiovasc Surg. 1998;39(2):151–62.Google Scholar
  14. 14.
    Zamboni P, Gasbarro V, Marcellino MG. External valvuloplasty of the sapheno-femoral junction. Vasc Surg. 1994;28:327–36.CrossRefGoogle Scholar
  15. 15.
    Zamboni P, Liboni A. External valvuloplasty of the s-f junction using perforated prosthesis. Phlebology. 1991;6:141–7.CrossRefGoogle Scholar
  16. 16.
    Zamboni P, Gasbarro V, De Anna D, Liboni A, Donini I. External valvuloplasty of the SFJ with intraoperative angioscopy. J Vasc Surg. 1993;17:438.Google Scholar
  17. 17.
    Belcaro G, Ricci A, Laurora G, Cesarone MR, De Sanctis MT, Incandela L. Superficial femoral vein valve repair and limited anterior plication. Phlebology. 1994;9:146–9.CrossRefGoogle Scholar
  18. 18.
    Mendoza E, Blättler W, Amsler F. Great saphenous vein diameter at the saphenofemoral junction and proximal thigh as parameters of venous disease class. Eur J Vasc Endovasc Surg. 2013;45(1):76–83.CrossRefGoogle Scholar
  19. 19.
    Rutheford RB, Sawyer JD, Jones DN. The fate of residual saphenous vein after partial removal or ligation. J Vasc Surg. 1990;12:422–6.CrossRefGoogle Scholar
  20. 20.
    Fligelstone L, Carolan G, Pugh N, Shandall A, Lane I. An assessment of the long saphenous vein for potential use as a vascular conduit after varicose vein surgery. J Vasc Surg. 1993;18:836–40.CrossRefGoogle Scholar

Copyright information

© Springer International Publishing AG, part of Springer Nature 2018

Authors and Affiliations

  1. 1.School of Vascular Surgery and Vascular Diseases CenterUniversity of FerraraFerraraItaly
  2. 2.Unit of Translational SurgeryAOU FerraraFerraraItaly
  3. 3.Vascular Diseases CenterUniversity of FerraraFerraraItaly
  4. 4.USUHS UniversityBethesdaUSA

Personalised recommendations