TY - CHAP M1 - Book, Section TI - Diagnosis and Management of Diseases of the Peripheral Venous System A1 - Kadian-Dodov, Daniella A1 - Johnston-Cox, Hillary A1 - Olin, Jeffrey W. A2 - Fuster, Valentin A2 - Narula, Jagat A2 - Vaishnava, Prashant A2 - Leon, Martin B. A2 - Callans, David J. A2 - Rumsfeld, John S. A2 - Poppas, Athena Y1 - 2022 N1 - T2 - Fuster and Hurst's The Heart, 15e AB - Chapter SummaryThis chapter reviews the pathophysiology and treatment of peripheral venous disease. The anatomy of the venous system is central to the diagnosis and management of acute and chronic venous disease (see Fuster and Hurst’s Central Illustration). Both intrinsic and extrinsic risk factors may contribute to venous thrombosis in the deep veins, calf veins, or superficial veins. Duplex ultrasonography is useful for diagnosis in most cases; computed tomography or magnetic resonance venography may be considered to evaluate pelvic vein thrombosis or outflow obstruction. Catheter-based venography is reserved for planned treatment. The cornerstone of medical therapy for venous thrombosis is anticoagulation. Advanced therapies such as inferior vena cava filter or catheter-directed thrombolysis and thrombectomy may be considered in specialized cases. Prior venous thrombosis is a risk factor for chronic venous disease, as well as family history, age, sex, parity, and obesity. Candidacy for advanced therapies may be assessed by duplex ultrasonography to quantify the extent of insufficiency and anatomy. Compression therapy is central to management of chronic venous disease; in refractory cases, endovenous ablation, vein stripping, or other surgical techniques may be considered. Venous ulcers require additional attention beyond compression to skin care, infection control, and assessment of arterial perfusion, which may be compromised in up to 26% of patients. SN - PB - McGraw-Hill Education CY - New York, NY Y2 - 2024/03/29 UR - accesscardiology.mhmedical.com/content.aspx?aid=1202456033 ER -