1. Technique in direct venous valvuloplasty
V.S. Sottiurai, MD, PhD 
Journal of Vascular Surgery 
Volume 8, Issue 5, Pages (November 1988)
DOI: / (88)
Copyright © 1988 Society for Vascular Surgery and International Society for Cardiovascular Surgery, North American Chapter Terms and Conditions

2. Fig. 1
Diagrammatic presentation of operative procedures. Vertical groin incision (a). Good exposure of the common femoral vein and the associated branches (b). Transverse plus vertical venotomy (c). Venous flaps retracted laterally to expose the valve cusps (d). Technique of tacking valve cusps to the wall at the commissure using double end suture (e).
Journal of Vascular Surgery 1988 8, DOI: ( / (88) )
Copyright © 1988 Society for Vascular Surgery and International Society for Cardiovascular Surgery, North American Chapter Terms and Conditions

3. Fig. 2
Drawing displays how double-ended suture (7-0 Prolene or CV-8 PTFE) is used to tack the cusps of the venous wall with the ligature placed exterior to the vein. Multiple tacking is frequently needed to achieve competency of the valve.
Journal of Vascular Surgery 1988 8, DOI: ( / (88) )
Copyright © 1988 Society for Vascular Surgery and International Society for Cardiovascular Surgery, North American Chapter Terms and Conditions

4. Fig. 3
Pictorial presentation to digitally test the competency of the valve before and after valvuloplasty. Left, Preoperative incompetent valve; right, postoperative incompetent valve.
Journal of Vascular Surgery 1988 8, DOI: ( / (88) )
Copyright © 1988 Society for Vascular Surgery and International Society for Cardiovascular Surgery, North American Chapter Terms and Conditions

5. Fig. 4
Photographic demonstration of operative digital testing of competency of the repaired valve.
Journal of Vascular Surgery 1988 8, DOI: ( / (88) )
Copyright © 1988 Society for Vascular Surgery and International Society for Cardiovascular Surgery, North American Chapter Terms and Conditions