ABSTRACT
Post-thrombotic syndrome can develop in up to two-thirds of patients with extensive deep vein thrombosis. Ligation of the deep veins was practiced previously to treat chronic post-thrombotic valvular incompetence. The post-thrombotic lesions can be varied: slight wall thickening, homogeneous or inhomogeneous; synechiae and septae; intraluminal fibrotic septum which creates a double channel; or considerable wall thickening with the fibrosis occupying a large part of the lumen. In the absence of randomized trials, the level of evidence on the efficacy of surgical treatment of post-thrombotic valvular incompetence is low. The femoral vein (FV) is subsequently anastomosed with the PFV, just distal to a competent valve of the profunda femoris vein. If the FV has post-thrombotic trabeculae, those have to be excised before the anastomosis is done. A short segment of the common FV is dissected, just enough for clamping, but a longer segment of the PFV and the FV need to be dissected for adequate transposition.
