Pelvic venous flow disorder represents a group of venous maladies characterized by alterations in normal pelvic venous flow patterns. These maladies include pelvic congestion syndrome, nutcracker syndrome, and May–Thurner syndrome. Pelvic venous flow disorder is a significant cause of chronic…
The nutcracker syndrome is characterized by entrapment and compression of the left renal vein between the abdominal aorta and the superior mesenteric artery (SMA) ( Figure 1 ). The underlying anatomic anomaly, first described by Gant in 1937, can lead…
Chronic venous ulcers reflect a complex interplay that involves sustained venous hypertension, leukocyte activation and inflammation, changes in the microcirculation, cytokine and matrix metalloproteinase (MMP) expression, and altered cellular function. The fundamental of nonoperative therapy in venous ulcer pathology is…
Treatment of incompetent perforating veins (ICPVs) has evolved through numerous approaches, each holding the promise of being less invasive and as a result associated with reduced morbidity. The goal of ablating ICPVs, however, has not changed. The interruption of ICPVs…
Chronic venous insufficiency (CVI) is the seventh leading cause of chronic debilitating disease in the United States. An estimated 25 million people in the United States have varicose veins, 2 million to 6 million have more advanced forms of CVI…
Chronic venous insufficiency (CVI) is common, ranging from primary varicose veins to valvular incompetence of the lower extremity veins. Most symptoms of CVI can be improved with bedrest and elevation of the legs. However, prolonged immobilization is impractical and dangerous…
The term chronic venous insufficiency (CVI) refers to a progression in the broad category of chronic venous disorders. In terms of the CEAP (clinical, etiologic, anatomic, pathophysiologic) classification, it refers to progression beyond uncomplicated varicose vein disease (C2) to swelling…
There has been an explosion of new technologies for the treatment of truncal vein reflux, and a bewildering range of endovenous thermal and chemical ablation modalities are now available, many having replaced traditional saphenous junction disconnection and stripping operations. Although…
Sclerotherapy has been employed for almost a century. It involves the endoluminal delivery of a chemical to destroy venous endothelial cells to produce occlusion and fibrosis. Venous hypertension and its effects are mitigated by closure of the incompetent venous circulation.…
Endovenous radiofrequency (RF) ablation is an effective therapy of varicose veins affecting the greater saphenous vein (GSV), the small saphenous vein (SSV), the anterior accessory greater saphenous vein (AAGSV), the posterior accessory greater saphenous vein (PAGSV), and straight venous segments.…