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Percutaneous management of chronic deep venous reflux: review of experimental work and early clinical experience with bioprosthetic valve

Dotter Interventional Institute, Department of Biomedical Engineering, Oregon Health & Science University, Portland, Oregon, USA

Barry Uchida

Dotter Interventional Institute, Department of Biomedical Engineering, Oregon Health & Science University, Portland, Oregon, USA

John Kaufman

Dotter Interventional Institute, Department of Biomedical Engineering, Oregon Health & Science University, Portland, Oregon, USA

Monica Hinds

Dotter Interventional Institute, Department of Biomedical Engineering, Oregon Health & Science University, Portland, Oregon, USA

Frederick S Keller

Dotter Interventional Institute, Department of Biomedical Engineering, Oregon Health & Science University, Portland, Oregon, USA

Josef Rösch

Dotter Interventional Institute, Department of Biomedical Engineering, Oregon Health & Science University, Portland, Oregon, USA

Abstract

Lower extremity chronic deep venous insufficiency (CDVI) is common and remains a major health problem worldwide. Selected patients benefited from direct deep vein valve surgical repair or valve transplantation. A major limitation of this approach is that most of the patients are not candidates for these procedures due to obstructions or residual thrombus throughout the vein. The past 15 years have witnessed experimental efforts at catheter-based management of CDVI. This review describes the initial designs and experimental evolution of a mechanical and bioprosthetic venous valve that can be implanted by using a transcatheter technique. These valves consisted of single, double, or triple cusp leaflets made of synthetic or biological materials attached to a carrier or frame. All described devices for percutaneous transcatheter valve placement rely on some form of a vascular stent for valve attachment.

Key Words: chronic venous insufficiency • endovenous treatment • percutaneous venous valve • stents • venous valves • venous valve transplantation

Vascular Medicine, Vol. 13, No. 1, 75-84 (2008)
DOI: 10.1177/1358863X07083474


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