Surgical treatment of deep venous insufficiency of the lower limb.

The substitute "valve" operation, using Technique II with a Silastic (polymeric silicone) tendon designed to produce a valve-like mechanism in the popliteal vein, was performed upon 162 lower limbs (145 patients) which had deep venous insufficiency. Results achieved by this procedure were assessed clinically by Doppler ultrasound and venous pressure measurements, and partially by phlebography. Clinical improvement in 154 of 162 limbs was associated with a reduction of ambulatory venous pressure, prolongation of refilling time, interruption of popliteal reflux by Doppler, and phlebographic evidence of a functioning substitute "valve" postoperatively.