Evidence-based medicine is best defined as “the conscientious, explicit, and judicious use of the current best evidence in making decisions about the care of individual patients.” Clinical practice guidelines evaluate the evidence in the scientific literature, assess the likely benefits…
Historical Background The past few decades have marked a change of focus in reporting outcomes for venous disease and therapy. Although treatments were regularly being offered for many venous conditions, the outcomes were only sporadically evaluated, and reporting methods were…
Vascular malformations are likely the single most misdiagnosed entity in the vascular system. Essentially, vascular malformations are errors in vasculogenesis with the particular characteristics of the lesion determined by the vessel in the vascular system that is involved. As a…
Because of the increased use of central venous catheters and implantable pacemakers and defibrillators, upper extremity deep venous thrombosis (UEDVT) has become more frequent. Central vein stenosis and thrombosis, usually from neointimal hyperplasia, are commonly seen in dialysis-dependent patients or…
Historical Background The treatment of telangiectasias was not seriously attempted until the 1930s, with Biegeleisen taking the credit for initially attempting an injection into the perivascular space around telangiectatic areas. Later, he implemented intravascular injections using homemade microneedles. These early…
Compression of the left renal vein (LRV) between the superior mesenteric artery (SMA) and the abdominal aorta was first described by Grant in 1937, who found the anatomic relationship analogous to a nut in a nutcracker. The first clinical report…
Venous disorders of the abdomen and pelvis are often referred to as a number of syndromes, including pelvic congestion, May-Thurner, and nutcracker syndrome (NCS), which are of historical significance, but inadequately reflect the underlying pathophysiology of these disorders. For example,…
Venous leg ulcers (VLUs) are an important medical problem. The chronic and recurrent nature of VLUs causes morbidity, severely reduces patient quality of life, and increases costs placed on health care systems. Standard care supported by evidence includes compression therapy…
Deep venous insufficiency and the techniques used to repair the valve damage or valve incompetence is technically challenging when compared with the treatment of superficial, perforator, and iliofemoral deep venous occlusive disease, and therefore has been relegated to a “last…
Historical Background In contrast with the right common iliac vein, which ascends almost vertically to the inferior vena cava (IVC), the left common iliac vein takes a more transverse course beneath the right common iliac artery, which may compress it…