Learn About Venous Disease

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Venous disease is deeper than varicose veins. The venous system of the lower extremities includes the deep veins, superficial veins, and perforator veins1.

Deep venous disease may result from obstruction and/or reflux. There are different types of venous obstructions:

  • Post-thrombotic syndrome (PTS)
  • Nonthrombotic iliac vein lesions (NIVL)1

Post-thrombotic syndrome and deep vein thrombosis (DVT) are serious venous disorders. DVT is when a blood clot forms in the deep veins of the legs, pelvis, or abdomen2. PTS is a long term complication that can develop after DVT. PTS occurs in approximately 20 – 50% of the DVT patient population3,4.

normal-vein-return

A nonthrombotic iliac vein lesion (NIVL) is an obstruction in the deep vein system that is not caused by a clot, such as May-Thurner Syndrome, Cockett Syndrome, or iliac vein compression syndrome5.

In order to properly diagnosis and treat outflow obstruction a more thorough diagnosis is required. This can be done through the use of a duplex ultrasound, venogram, and/or intravascular ultrasound (IVUS).

Venous disorders with an obstructive component can be safely and successfully treated with stenting6.

vein-image

venous-disease-left

Venogram of an Occluded Left Iliac Vein due to PTS, Pre-Stenting
1. Obstructed Left Illiac Vein.
2. Collateral Vein Developed as a Return Pathway; collaterals such as this can cause congestion, pain, and discomfort.
venous-disease-right

Venogram of an Occluded Left Iliac Vein due to PTS, Post-Stenting – Collateral is Gone!
3. Stented – Left Iliac Vein.

References

  1. Meissner MH. Lower extremity venous anatomy. Semin Intervent Radiol. 2005;22:147–156.
  2. Comerota A, Eklof B, Martinez J, Mclafferty R. Surgical/Interventional Treatment of Acute Deep Vein Thrombosis. In: Gloviczki P eds. The Layman’s Handbook of Venous Disorders. Provided by the American Venous Form: veinforum.org.
  3. Prandoni P, Lensing A, Cogo A, et al. The long-term clinical course of acute deep venous thrombosis. Ann Intern Med 1996;125(1):1-7
  4. Kahn SR, Shrier I, Julian JA, et al. Determinants and time course of the post-thrombotic syndrome after acute deep venous thrombosis. Ann Intern Med 2008;149:698-707