Nearly all vascular interventions are prone to the development of neointimal hyperplasia because any manipulation of the arterial wall induces endothelial cell injury. Current enthusiasm for less invasive but more locally injurious percutaneous peripheral vascular therapies increases the importance of…
Introduction Access to the vascular system in order to perform life-sustaining dialysis in the face of renal failure remains an important and challenging clinical scenario for vascular surgeons. The number of individuals requiring vascular access for hemodialysis continues to rise.…
Lymphedema is an important topic for vascular surgeons for three reasons. First, it is very common. There are hundreds of thousands of lymphedema patients in the United States, and hundreds of millions are affected worldwide. Second, even the best surgeons…
Portal hypertension and variceal hemorrhage are important clinical problems in which vascular surgeons may still have a significant interest and concern. New developments have altered the once-familiar approach to this disease, with endoscopic and endovascular approaches having replaced what was…
A venous leg ulcer is defined as “an open skin lesion of the leg or foot that occurs in an area of venous hypertension.” Venous ulcers are one of the most common chronic vascular diseases: they are estimated to have…
The term chronic venous insufficiency (CVI) encompasses a spectrum of symptoms, such as edema, skin changes, or ulceration, which are attributed to functional abnormalities of the venous system and, in turn, venous hypertension. Varicose veins alone are not considered evidence…
Percutaneous endovenous stenting has emerged as a powerful technique for treating chronic venous obstructions. Stenosis and chronic total occlusions (CTOs) are amenable to endovascular correction. The technique is minimally invasive, safe, and effective and does not preclude open correction in…
Reconstruction of the occluded iliofemoral vein or the inferior vena cava (IVC) may be required in patients with postthrombotic venous occlusion if they exhibit signs and symptoms of advanced chronic venous insufficiency (CVI). Reconstruction of large veins may also be…
Introduction Thrombolytic therapy for venous thromboembolism is an increasingly important option for the management of patients with extensive venous thromboembolic disease, namely iliofemoral venous thrombosis and pulmonary embolism (PE), which alter venous and cardiopulmonary hemodynamics and cause pathologic myocardial stretch…
Venous thromboembolism (VTE), which includes both deep venous thrombosis (DVT) and pulmonary embolism (PE), is very common. Although the etiology of acute venous thrombosis (VT) is defined by Virchow triad of hypercoagulability, stasis, and endothelial injury, it is clearly a…