Rationale of the substitute "valve" operation by technique II in the treatment of chronic venous insufficiency.

The substitute valve operation by Technique II, using a silicone tendon to produce a valve-like mechanism in the popliteal vein, is described. The results in 34 limbs have been assessed by ambulatory venous pressure measurements and by phlebography. Clinical improvement in 32 limbs was associated with improvement in the ambulatory venous pressure and phlebographic evidence of a functioning substitute valve. The efficacy of the substitute valve was studied in limbs operated on by Technique II without operating on the superficial veins. The ambulatory venous pressure and Doppler ultrasound confirmed the absence of popliteal reflux in limbs treated by Technique II.