What is the prognosis of venous insufficiency?

Updated: Oct 22, 2018
  • Author: Robert Weiss, MD; Chief Editor: William D James, MD  more...
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Answer

Outcomes for different therapies have varied. Clot lysis (eg, with tissue plasminogen activator or urokinase) and thrombectomy have been tried but have largely been abandoned because of the extremely high recurrence rates.

Saphenous vein crossover grafting for iliofemoral disease has a relatively high failure rate (20%), and thus, ringed polytetrafluoroethylene (PTFE) grafts are now being used. Long-term patency rates have not been determined. The Husni bypass for superficial femoral vein occlusion has an even higher failure rate (approximately 40%) and thus is now performed infrequently.

Surgery for CVI resulting from deep vein incompetence includes valvuloplasty and allograft or cadaveric vein transplant. Valvuloplasty for patients with congenital absence of functional valves, when combined with ligation of perforating veins, yields a superior outcome in 80% of cases after 5 years. Allograft or cadaveric vein transplants are undergoing further evaluation, with long-term results pending.


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