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.…
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…
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…
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…
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…
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…
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…
Historical Background Treatment of this disorder has evolved from sclerotherapy to open radical surgery and then to the use of sophisticated technology, such as thermal and nonthermal catheter-based ablation. The exact historical point in time when saphenous vein incompetence was…
Historical Background Of the 25 million Americans with venous disease, approximately 7 million exhibit serious symptoms such as edema, skin changes, and venous ulcers. One million seek formal medical advice annually. Diagnostic testing is used to identify, grade, and follow…
Historical Background Chronic venous diseases include a spectrum of clinical findings ranging from spider telangiectasias and varicose veins to debilitating venous ulceration. Varicose veins without skin changes are present in about 20% of the general population, and they are slightly…