Deep venous reconstruction (1968-1984).

This paper describes our overall experience with venous reconstructive surgery in the past 15 years. A thorough diagnostic evaluation of the patient with advanced chronic venous insufficiency is necessary to guide the surgeon in selecting a surgical approach that will address the specific problem in each patient. The diagnostic workup will separate those with insufficiency due to valve incompetence from those with deep vein obstruction as the basis for their problem. The operations vary from vein ligations to valve reconstruction or transplantation for valve incompetence and venous bypasses for obstructive problems. An aggressive surgical attitude in chronic venous disease makes it possible to restore selected patients to full activity with symptom-free extremities rather than teaching them to live within the confines of their disease state by nonsurgical management.