In the United States each year about 15,000 patients develop symptoms of venous congestion of the head and neck due to occlusion of the superior vena cava (SVC) or innominate veins. SVC syndrome is caused by malignant tumors of the…
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…
Minimally invasive endoscopic technology has rapidly transformed both thoracic and abdominal surgery, and the field of surgical sympathectomies is no exception. For thoracic sympathectomy, the thoracoscopic procedure is used almost exclusively. Laparoscopic and retroperitoneoscopic techniques have also been developed for…
Vascular malformations (VMs) are developmental abnormalities of the vascular system. They should be differentiated from vascular tumors or hemangiomas because they have different etiologies, growth patterns, treatments, and outcomes. Malformations can involve any segment of the vascular tree: arteries, capillaries,…
Physical therapy, compression garments, manual lymphatic drainage, and intermittent pneumatic compression pumps are currently the first line of treatment in patients with chronic lymphedema. Current guidelines recommend that surgical management can be attempted in selected patients who have failed conservative…
Thrombotic occlusions of the superior vena cava (SVC) or the inferior vena cava (IVC) requiring open surgical reconstruction are uncommon in the endovascular era. Chronic caval obstruction is usually the result of a previous acute deep vein thrombosis (DVT), which…
Aortic reconstructions for an abdominal aortic aneurysm (AAA) in kidney transplant recipients have been increasing steadily since the 1990s for a variety of reasons: These patients often have accelerated atherosclerosis caused by hemodialysis and other cardiovascular risk factors; renal transplantation…
Historical Background In 1757 Hunter was the first to describe a patient with compression of the superior vena cava (SVC) by a large syphilitic aortic aneurysm leading to thrombosis. In 1954 Schechter reported a series of 400 patients with SVC…
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…
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…