Lower deep vein disease

Jovan N. Markovic, Mitchell Cox

Research output: Chapter in Book/Report/Conference proceedingChapter


Deep venous insufficiency may manifest as limb edema, chronic leg pain, stasis dermatitis, or ulceration, and the symptoms may be chronically disabling. Initial therapy is directed at ulcer healing and control of symptoms with wound care and compression. Once conservative measures have been instituted, the next step may be evaluation for any surgically correctable contributors to the symptomatology. Although valvular dysfunction and consequent venous reflux are a major cause of the venous hypertension that underlies the clinical manifestations of chronic venous insufficiency (CVI), recent studies suggest that iliac venous outflow obstruction plays a more important role in the pathogenesis of CVI than previously estimated. Any combination of superficial, perforator, and/or deep venous reflux can result in various stages of CVI, but when multiple segments of venous system are affected, the manifestations of CVI increase in severity. The combination of reflux and obstruction produces the highest levels of venous hypertension and the most severe clinical symptoms. This chapter discusses iliocaval vein obstructions and pelvic venous congestion.

Original languageEnglish (US)
Title of host publicationPhlebology, Vein Surgery and Ultrasonography
Subtitle of host publicationDiagnosis and Management of Venous Disease
PublisherSpringer International Publishing
Number of pages16
ISBN (Electronic)9783319018126
ISBN (Print)9783319018119
StatePublished - Jan 1 2014
Externally publishedYes

ASJC Scopus subject areas

  • General Medicine


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