Chronic venous insufficiency and bioprosthetic bicuspid square stent based venous valve for transcatheter placement

The past 25 years have witnessed experimental efforts at catheter-based management of aortic, pulmonary and venous valve regurgitation. This chapter describes the initial designs and experimental evolution of a bioprosthetic venous valve that can be implanted by using a transcatheter technique. An evaluation of a percutaneously placed bioprosthetic, bicuspid venous valve (BBVV) consisting of a square stent and small intestinal submucosa (SIS) covering was performed in 15 sheep. Of 30 BBVVs placed into the jugular veins, 28 exhibited good valve function on immediate venograms, and 25 on venograms prior to sacrifice. Gross and histologic examinations demonstrated incorporation of remodeled and endothelialized SIS BBVVs into the vein wall. Minimally invasive placed square stent based SIS valve is a promising one-way, competent valve.