Peripheral Vascular Surgery Society

#24 A STUDY OF SUPERFICIAL FEMORAL VEIN VALVE FUNCTION AT HIGHER PRESSURES.

John H. Matsuura, MD, Daniel A. Mullis, MD, Kathryn A. Clarke, BS, David Rosenthal, MD, and Michael D. Clark, MD

The Atlanta Medical Center, Atlanta, GA

Background: Chronic venous insufficiency (CVI) is one of the most common vascular disorders in the United States affecting over 2.5 million people. Although extensive research has been conducted on CVI and the pathophysiology of venous stasis ulceration, not much is known about the function of normal femoral vein valves. We retrospectively reviewed a vein donor bank to assess the characteristics of the femoral veins with respect to their valve function at high pressures.

Methods: Between January 1997 and January 1999, the data from 273 donor femoral veins were available for analysis. All donors with a history of varicose veins, deep venous thrombosis, CVI, or pulmonary embolism were not eligible for vein donation and therefore excluded from the study. All donors were males. Patient characteristics of age, height, and weight were recorded. At the time of vein tissue processing, findings of duplicate vein patterns, the number of valves, vein length and diameter were also noted on the database. Finally, the valves were tested by distending the veins by retrograde perfusion using heparinized lactated ringers solution to a pressure limit of 120 mm Hg to determine valve competence at high pressures. Statistical comparison was calculated using Fisher's Exact test.

Results: The mean donor age was 26 years (range 16-45 years). The length of the femoral vein arising from the popliteal veins below the adductor canal to the insertion into the common femoral vein was 20±3.0 cm and a duplicate system was seen 15% of the time. The distal vein diameter was 0.9±0.1 cm with an average proximal diameter of 1.0±0.2 cm. The femoral veins averaged 2.3±1.2 valves, and 6 femoral veins had a complete absence of valves. Only 82 (30%) of the femoral veins had competent valves at 120 mm Hg pressure. There was no correlation between age (p=1.05), hwifhr (p=0.975), weight (p=0.992), or vein diameter (p=0.962) and the incidence of valvular dysfunction at high pressure.

Conclusion: Patients with CVI can generate deep venous pressures as high as 60-90 mm Hg. Our results indicate that 70% of young adults with normal deep veins have valves that cannot withstand high pressures. It may also indicate that valvular insufficiency of the femoral vein on duplex scans may be a relatively normal findings.

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Last updated January 1,2000