Skip to main content
SpringerLink
Log in

Endovascular Therapy for Chronic Venous Obstruction

  • Chapter
Chronic Venous Insufficiency

Abstract

Severe chronic venous insufficiency (CVI) is characterized by reflux through the superficial venous system as well as the deep venous system. These phenomena are found in concert with perforating vein outflow. A sizable fraction of patients with chronic venous insufficiency has experienced deep venous thrombosis and some carry persistent venous occlusions. Reports from the Subfascial Perforating Vein Registry have emphasized the importance of such venous obstruction in failures of perforator vein surgery. Surgical approaches to correcting the pathophysiology of venous obstruction have been disappointing. Therefore, exploration of endovascular therapy for chronic venous obstruction has certain appeal.

This is a preview of subscription content, log in via an institution to check access.

Access this chapter

Log in via an institution
Chapter
USD 29.95
Price excludes VAT (USA)
  • Available as PDF
  • Read on any device
  • Instant download
  • Own it forever
eBook
USD 39.99
Price excludes VAT (USA)
  • Available as EPUB and PDF
  • Read on any device
  • Instant download
  • Own it forever
Softcover Book
USD 54.99
Price excludes VAT (USA)
  • Compact, lightweight edition
  • Dispatched in 3 to 5 business days
  • Free shipping worldwide - see info

Tax calculation will be finalised at checkout

Purchases are for personal use only

Institutional subscriptions

Preview

Unable to display preview. Download preview PDF.

Unable to display preview. Download preview PDF.

References

  1. Browse NL, Clemenson G, Lea Thomas M. Is the postphlebitic leg always postphlebitic? Relation between phlebographic appearance of deep venous thrombosis and late sequelae. Br Med J 1980; 282:1167

    Article  Google Scholar 

  2. Cranley JJ, Krause RJ, Strasser ES. Chronic venous insufficiency of the lower extremity. Surgery 1961; 49:68

    Google Scholar 

  3. Beyth RJ, Cohen AM, Landefeld CS. Long-term outcomes of deep venous thrombosis. Arch Intern Med 1995; 155:1031–3

    Article  PubMed  CAS  Google Scholar 

  4. Lindner DJ, Edwards JM, Phinney ES et al. Long-term hemodynamic and clinical sequelae of lower extremity DVT. J Vasc Surg 1986; 4:436–2

    PubMed  CAS  Google Scholar 

  5. Lagerstedt CI, Olsson CG, Fagher BO et al. Need for long-term anticoagulant treatment in symptomatic calf vein thrombosis. Lancet 1985; 2:515–18

    Article  PubMed  CAS  Google Scholar 

  6. Sevitt J. The mechanisms of canalization in deep venous thrombosis. J Pathol 1973; 110:153–65

    Article  PubMed  CAS  Google Scholar 

  7. Widmer LK, Zemp E, Widmer MT et al. Late results in deep vein thrombosis of the lower extremity. Vasa 1985;14(3):264–8

    PubMed  CAS  Google Scholar 

  8. Bauer G. A venographic study on thromboembolic problems. Acta Chir Stand 1940: 84(61):1–75

    Google Scholar 

  9. Browse NL, Burnand KG, Thomas ML. The calf pump failure syndrome. In: Browse NL, Burnand KG, Thomas ML (eds) Diseases of the veins: pathology, diagnosis and treatment. Edward Arnold, London 1988: 301–23

    Google Scholar 

  10. Tsapogas MJ, Flute PT, Cotton LT, Milroy SD. Lysis of experimental thrombi by streptokinase. Br J Surg 1962; 50:334

    Article  PubMed  CAS  Google Scholar 

  11. Nilsson IM, O1ow B. Fibrinolysis induced by streptokinase in man. Acta Chir Stand 1962; 123:247

    Google Scholar 

  12. Cotton LT, Flute PT, Tsapogas MJ. Popliteal artery thrombosis treated with streptokinase. Lancet 1962; 2:1081

    Article  PubMed  CAS  Google Scholar 

  13. Robertson BR, Nillson IM, Nylander G. Value of streptokinase and heparin in treatment of acute deep venous thrombosis. Acta Chir Stand 1968; 134:203–8

    CAS  Google Scholar 

  14. Kakkar VV, Flanc C, Howe CT et al. Treatment of deep venous thrombosis: a trial of heparin, streptokinase and arvin. Br Med J 1969; 1:806

    Article  PubMed  CAS  Google Scholar 

  15. Mayor GE, Bennett B, Galloway M, Karmody AM. Streptokinase in iliofemoral venous thrombosis. Br J Surg 1969; 56:564

    Article  Google Scholar 

  16. Robertson BR, Nillson IM, Nylander G. Thrombolytic effect of streptokinase as evaluated by phlebography of deep venous thrombi of the leg. Acta Chir Stand 1970; 136:173

    CAS  Google Scholar 

  17. Sharma CVRK, O’Connell DJ, Belko JS, Sasahara AA. Thrombolytic therapy in deep vein thrombosis. Academic Press, London, 1977: 181–9

    Google Scholar 

  18. Nachbur BB, Beck EA, Jenn A. Can the results of treatment of deep venous thrombosis be improved by combining surgical thrombectomy with regional thrombolysis? J Cardiovasc Surg 1980; 21:347

    CAS  Google Scholar 

  19. Meissner AJ, Misiak A, Ziemski JM et al. Hazards of thrombolytic therapy in deep venous thrombosis. Br J Surg 1987; 74:991–3

    Article  PubMed  CAS  Google Scholar 

  20. Goldhaber SZ, Buring JE, Lipnick RJ, Hennekens СH. Pooled analyses of randomized trials of streptokinase and heparin in phlebographically documented acute deep venous thrombosis. Am J Med 1984; 76:393–7

    Article  PubMed  CAS  Google Scholar 

  21. LeVeen HH, Diaz CA. Venous and arterial occlusive disease treated by enzymatic clot lysis. Arch Surg 1972; 105:927

    Article  PubMed  CAS  Google Scholar 

  22. Tsapogas MJ, Peabody RA et al. Controlled study of thrombolytic therapy in deep venous thrombosis. Surgery 1973; 74(6):973–84

    PubMed  CAS  Google Scholar 

  23. Dotter CT, Rosch J, Seaman AJ. Selective clot lysis with low-dose streptokinase. Radiology 1974; 111:31

    PubMed  CAS  Google Scholar 

  24. Marder VJ, Soulen RL et al. Quantitative venographic assessment of deep venous thrombosis in the evaluation of streptokinase and heparin therapy. J Lab Clin Med 1977; 89(5):1018

    PubMed  CAS  Google Scholar 

  25. Albrechtsson М, Anderson J, Einarsson E. Streptokinase treatment of deep venous thrombosis and the post-thrombotic syndrome. Arch Surg 1981; 116:33–7

    Article  PubMed  CAS  Google Scholar 

  26. Katzen BT, Edwards K, Arthur A, Van Breda A. Low-dose direct fibrinolysis in peripheral vascular disease. J Vasc Surg 1984; 1:718–22

    PubMed  CAS  Google Scholar 

  27. McNamara TO, Fischer JR. Thrombolysis of arterial and graft occlusions: improved results using high-dose urokinase. Am J Radiol 1985; 144:769–5

    CAS  Google Scholar 

  28. LeBlang DS, Becker GJ, Benenati JF, Zemel G, Katzen BT, Sallee JS. Low-dose urokinase regimen for the treatment of lower extremity arterial and graft occlusions: Experience in 132 cases. J Vasc Intervent Radiol 1992; 3:474–83

    Article  Google Scholar 

  29. McNamara TO. Complications in thrombolysis. Sem Int Rad 1994; 11:134–44

    Article  Google Scholar 

  30. Becker LJ, Holden RW, Rabe FE et al. Local thrombolytic therapy for subclavian and axillary vein thrombosis. Radiology 1983; 149:419–23

    PubMed  CAS  Google Scholar 

  31. Druy EM, Trout HH et al. Lytic therapy in the treatment of axillary and subclavian vein thrombosis. J Vasc Surg 1985; 2:821–27

    PubMed  CAS  Google Scholar 

  32. Macheleder HI. Upper extremity venous thrombosis. Sem Vasc Surg 1990; 3:1–8

    Google Scholar 

  33. Thorpe PE, Siffring PA, Hunter DW. Direct lower extremity infusion of urokinase for the treatment of acute and subacute deep venous thrombosis. Radiology 1989; 173(Р):621

    Google Scholar 

  34. Okrent D, Messersmith RO, Buckman J. Transcatheter fibrinolytic therapy and angioplasty for left iliofemoral venous thrombosis. J Vasc Intervent Radiol 1991; 2:195–200

    Article  CAS  Google Scholar 

  35. Molina JE, Hunter DW, Yedlika JW. Thrombolytic therapy for iliofemoral venous thrombosis. J Vasc Surg 1992; 630–7

    Google Scholar 

  36. Semba CP, Dake MD. Catheter-directed venous thrombolysis. Semin Int Rad 1994; 11(4):388–95

    Article  Google Scholar 

  37. Comerota AJ, Aldridge SC, Gohen G et al. A strategy of aggressive regional therapy for acute iliofemoral venous thrombosis with contemporary venous thrombectomy for catheter-directed thrombolysis. J Vasc Surg 1994; 20:244–54

    Article  PubMed  CAS  Google Scholar 

  38. Cragg AH. Lower extremity deep venous thrombolysis: a new approach to obtaining access. JVIR 1996; 7:283–8

    Article  PubMed  CAS  Google Scholar 

  39. Bjorgell O, Ekberg O, Akesson H, Olsson R. Videophlebography with foot venous pressure measurements: Description of a technique for diagnosing venous dysfunction. Phlebology 1997; 12:100–6

    Google Scholar 

  40. Hansen MCH, Wollersheim H, van Asten WNJC et al. The post-thrombotic syndrome: A review. Phlebology 1996; 11:86–94

    Google Scholar 

  41. Markel A, Manzo RA, Strandness DE Jr. The potential role of thrombolytic therapy in venous thrombosis. Arch Intern Med 1992; 152:1265–67

    Article  PubMed  CAS  Google Scholar 

  42. Semba CP, Dake MD. Iliofemoral deep venous thrombosis: aggressive therapy using catheter-directed thrombolysis. Radiology 1994; 191:487–94

    PubMed  CAS  Google Scholar 

  43. Moneta GL. The case against aggressive treatment. Vasc Surg 1997; 31(3):320–21

    Article  Google Scholar 

  44. Wells PS, Hirsh J, Anderson DR et al. Accuracy of clinical assessment of deep venous thrombosis. Lancet 1995; 345:1326–30

    Article  PubMed  CAS  Google Scholar 

  45. van Bemmelen PS, Bedford G, Beach K, Strandness DE Jr. Status of the valves in the superficial and deep venous system in chronic venous disease. Surgery 1991; 109:130–9

    Google Scholar 

  46. Meissner MH, Manzo RA, Bergelin RO et al. Deep venous insufficiency: the relationship between lysis and consequent reflux. J Vasc Surg 1993; 18:596–608

    Article  PubMed  CAS  Google Scholar 

  47. Killewich LA, Bedford GR, Beach KW, Strandness DE Jr. Spontaneous lysis of deep venous thrombi: Rate and outcome. J Vasc Surg 1989; 9:89–97

    PubMed  CAS  Google Scholar 

  48. Mohrman DE, Heller U. Homeostasis and cardiovascular transport. In: Hefta J, Melvin S (eds) Cardiovascular physiology, 4th edn. McGraw-Hill Co., New York, 1997: 1–8

    Google Scholar 

  49. Van Den Oever R, Hepp B, Debbaut B, Simon I. Socioeconomic impact of chronic venous insufficiency: An underestimated public health problem. Int Angiol 1998; 17:161–7

    PubMed  Google Scholar 

  50. Baker SR, Stacy AG, Jopp-McKay AG et al. Epidemiology of chronic venous ulcers. Br J Surg 1991; 78:864–7

    Article  PubMed  CAS  Google Scholar 

  51. Johnson BF, Manzo RA, Bergelin RO, Strandness DE Jr. Relationship between changes in the deep venous system and the development of the post-thrombotic syndrome after an acute episode of lower limb deep venous thrombosis: a one-to six-year follow-up. J Vasc Surg 1995; 21:307–13

    Article  PubMed  CAS  Google Scholar 

  52. Lagersted C, Olsson CG, Fagher B et al. Recurrence and late sequelae after first-time deep venous thrombosis: Relationship to initial lysis. Phlebology 1993; 8:62–7

    Google Scholar 

  53. Nazarian GK, Austin WR, Wegryn SA et al. Venous recanalization by metallic stents after failure of balloon angioplasty or surgery: four-year experience. Cardiovasc Intervent Radiol 1996; 19:227–33

    Article  PubMed  CAS  Google Scholar 

Download references

Authors
  1. Patricia E. Thorpe
    View author publications

    You can also search for this author in PubMed Google Scholar

Editor information

Editors and Affiliations

  1. Division of Vascular Surgery, Loma Linda University Medical Center, 11175 Campus St, RM#21123, Loma Linda, California, CA, 92354, USA

    Jeffrey L. Ballard MD, FACS

  2. North Coast Surgeons, 9850 Genessee Avenue, Suite 560, La Jolla, California, CA, 92037, USA

    John J. Bergan MD FACS

Rights and permissions

Reprints and permissions

Copyright information

© 2000 Springer-Verlag London

About this chapter

Cite this chapter

Thorpe, P.E. (2000). Endovascular Therapy for Chronic Venous Obstruction. In: Ballard, J.L., Bergan, J.J. (eds) Chronic Venous Insufficiency. Springer, London. https://doi.org/10.1007/978-1-4471-0473-5_17

Download citation

  • DOI: https://doi.org/10.1007/978-1-4471-0473-5_17

  • Publisher Name: Springer, London

  • Print ISBN: 978-1-4471-1149-8

  • Online ISBN: 978-1-4471-0473-5

  • eBook Packages: Springer Book Archive

Publish with us

Policies and ethics

Search

Navigation