Chronic venous obstruction (CVO) is a term used to describe venous obstruction related mostly to a previous deep vein thrombosis (DVT). Post-thrombotic changes occur in the form of fibrosis and scarring within deep veins. In some cases CVO can be caused by congenital abnormalities like vein aplasia, hypoplasia or agenesis. Occasionally, chronic mechanical obstruction is… Read More »
Crossectomy is a procedure which ligates the great saphenous vein (GSV) at its termination into the femoral vein. Usually, all the draining tributaries are ligated similarly as they join the GSV termination. The procedure can be performed under local or general anaesthetic. It can be combined with stripping of the GSV or performed alone if… Read More »
Spider veins or telangiectasias are the commonest clinical CEAP class, documented as C1, with many patients seeking treatment to improve the appearance of their legs. They may be blue or red and are distinguished from reticular veins which have a profile. If they are present around the ankle, then they may be part of a… Read More »
Surrogate markers or endpoints are those which evaluate the effect of a treatment in the hope that they represent a meaningful clinical endpoint. What matters is whether a treatment for varicose veins has alleviated the presenting symptoms and not whether sites of reflux have been obliterated or the venous filling index has improved. Clinical endpoints… Read More »
Understanding the way valves work have moved on from the simple open and close movement. Their function is to counter the gravitational forces, lower ambulatory venous pressure and facilitate antegrade flow back towards the heart. Therefore, they play a critical role in the maintenance of a healthy venous system. Valve failure leads to retrograde leakage… Read More »
Trans-vaginal ultrasound (TVU) is a way of assessing the pelvic veins. It should be performed in women when a reflux source is suspected arising from above the sapheno-femoral junction. Approximately a sixth of women have a refluxive saphenous vein fed from above. Accurate evaluation of all reflux sources is essential to direct durable treatment options.… Read More »