Atlas of Endovascular Venous Surgery

Postthrombotic Syndrome

Historical Background Postthrombotic syndrome (PTS) remains an important health care problem in United States. A population-based study showed that the incidence of venous ulcers currently approaches 18 per 100,000 habitants per year. The same study identified that PTS is responsible…

Endothermal Heat-Induced Thrombosis

Historical Background Endothermal ablation techniques used to treat superficial venous reflux, such as endovenous laser ablation (EVLA) and radiofrequency ablation (RFA), use heat to induce endothelial injury. This results in a combination of thrombosis, fibrosis, subsequent vein contracture, and eventual…

New Concepts in the Management of Pulmonary Embolus

Historical Background Demographics Acute pulmonary embolism (PE) continues to be a major cause of morbidity and mortality worldwide. There are approximately 530,000 cases of symptomatic PE, and almost 300,000 deaths each year from acute venous thromboembolisms. The International Cooperative Pulmonary…

Pharmacomechanical Thrombolysis

Historical Background Venous thromboembolism (VTE) remains a significant health problem with over 900,000 new episodes each year in the United States alone. VTE, which comprises both deep venous thrombosis (DVT) and pulmonary embolism (PE), is responsible for up to 300,000…

Endovenous Placement of Inferior Vena Caval Filters

Historical Background Venous interruption for the prevention of pulmonary embolism (PE) was introduced by Homans in 1934. Although his initial description involved ligation of the femoral vein, surgical techniques soon evolved, focusing on interruption at the level of the inferior…

Thromboembolic Disease

Historical Background and Epidemiology of Acute Venous Thromboembolic Disease The incidence of deep venous thrombosis (DVT) ranges from 5 to 9 per 10,000 person-years in the general population, and the incidence of venous thromboembolism (VTE), defined as DVT and pulmonary…

Endovenous Approach to Recurrent Varicose Veins

Historical Background Recurrence rates of varicose veins of 20% are common, with rates as high as 70% at 10 years. Up to 25% of procedures for varicose veins are performed for recurrent disease, thus placing considerable demands on health care…

Treatment of Varicosed Tributary Veins

Historical Background Ambulatory phlebectomy (AP) is a minor surgical procedure designed to remove varicose vein clusters located close to the skin surface. Originally performed in ancient Rome, the technique was published by Robert Muller in 1966. In many office-based, venous…

Treatment of Perforating Veins

Historical Background Although the role of perforator veins (PVs) in the development of signs and symptoms remains unclear, the number of incompetent PVs and the size of both competent and incompetent PVs have been shown to increase with worsening chronic…

Nonthermal Ablation of Saphenous Reflux

All endovenous technologies can be classified under two general categories: thermal tumescent (TT) or nonthermal nontumescent (NTNT). The TT technologies include radiofrequency, laser, and steam. NTNT technologies encompass: mechanical occlusion chemically assisted (MOCA), cyanoacrylate closure (CAC), and polidocanol injectable microfoam…