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At present, there are no widely accepted surgical or percutaneous treatment options for chronic venous insufficiency of the deep venous system. The small intestinal submucosa square stent bicuspid venous valve (BVV) has shown the most promising results of artificial venous valves developed to date. In experimental long-term studies in sheep jugular veins, 88% of implanted valves exhibited good function; 12% had decreased function related to valve tilting, of which only 4% had partial thrombosis. BVVs were also placed in three patients and have remained patent without thrombosis or other complications since 2002. At present, 3 years after BVV placement, symptoms in two patients are decreased. Proper sizing and proper placement of the valves were critical to their function. To eliminate occasional tilting of the original BVV, a second-generation BVV has been developed and tested.

Percutaneous Therapy for Deep Vein Reflux