Replacement of the Deep Veins of the Leg

The many patients with chronically swollen and frequently ulcerated legs remain an eloquent testimony to the inadequacy of our present methods of treatment of the postphlebitic legs. The principles of vessel replacement which have been so effective in the surgical treatment of arterial insufficiency have usually been neglected and the modern principles of treatment of venous insufficiency are still mainly those of support, ligation, or excision.

Of the various materials with which surgeons have attempted to replace the veins of the leg, satisfactory patency rates and continued valve function have been achieved only with venous autografts. The reported patency rates with venous autografts in the femoral vein of the dog have varied widely but in general have been less than those achieved when the graft was used to replace veins of similar size in other areas such as the renal vein or jugular vein.^1,2 DeWeese and Niguidula,³ and