RT Book, Section
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
A2 Poppas, Athena
SR Print(0)
ID 1202456033
T1 Diagnosis and Management of Diseases of the Peripheral Venous System
T2 Fuster and Hurst's The Heart, 15e
YR 2022
FD 2022
PB McGraw-Hill Education
PP New York, NY
SN 9781264257560
LK accesscardiology.mhmedical.com/content.aspx?aid=1202456033
RD 2023/09/25
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.