This article considers the potential options for open deep venous reconstructions based on pathologic complication (obstruction vs insufficiency), anatomic location, presence of disease-free venous architecture, and patient need. Other things being equal, less invasive techniques and disease locations will be attempted as first-line therapy. When other options fail and symptoms persist, open venous surgery by means of bypass for obstructive disease and valve repair or replacement for deep venous insufficiency remains a viable option. The basic techniques available and overall success rates of each are considered.
Keywords: Deep venous insufficiency; Deep venous obstruction; Venous bypass; Venous transplantation; Venous transposition; Venous valve repair; Venous valve replacement; Venous valvuloplasty.
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