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T H E V E I N B O O K

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T H E V E I N B O O K
SECOND EDITION
EDITED BY
J o h n J . B e r g a n
Nisha Bunke-Paquette
1

3
https://t.me/med1917
Oxford University Press is a department of the University of
Oxford. It furthers the University’s objective of excellence in research,
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© Oxford University Press 2014
All rights reserved. No part of this publication may be reproduced, stored in
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permission in writing of Oxford University Press, or as expressly permitted by law,
by license, or under terms agreed with the appropriate reproduction rights organization.
Inquiries concerning reproduction outside the scope of the above should be sent to the
1. Venous Insu ciency. 2. Veins—physiopathology. 3. Venous romboembolism. WG 600]
[DNLM:
Rights Department, Oxford University Press, at the address above.
You must not circulate this work in any other form
and you must impose this same condition on any acquirer.
Library of Congress Cataloging-in-Publication Data
e vein book / edited by John J. Bergan, Nisha Bunke-Paquette.—2nd ed.
p. ; cm.
Includes bibliographical references and index.
ISBN 978–0–19–539963–9
I. Bergan, John J., 1927– II. Bunke-Paquette, Nisha.
RC695
616.1′4—dc23
2013016280
1 3 5 7 9 8 6 4 2
Printed in the United States of America
on acid-free paper

C O N T E N T S
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Contributing Author List ix
P A R T I
B A S I C C O N S I D E R A T I O N S
1. Historical Introduction 3
Alberto Caggiati and Claudio Allegra
2. Venous Embryology and Anatomy 17
Geza Mozes and Peter Gloviczki
3. Epidemiology of Chronic Peripheral Venous Disease 27
Michael H. Criqui , Julie O. Denenberg , Robert D. Langer ,
Robert M. Kaplan , and Arnost Fronek
4. Venous Anatomy, Physiology, and Pathophysiology 37
John J. Bergan and Luigi Pascarella
5. Role of Physiologic Testing in Venous Disorders 43
Je rey K. Raines and Jose I. Almeida
6. Inappropriate Leukocyte Activation
in Venous Disease 50
Philip Coleridge Smith
7. Chronic Venous Insu ciency:Molecular
Abnormalities and Ulcer Formation 58
J o s e p h D . R a e t t o
8. Pathophysiology of Chronic Venous Insu ciency 67
Peter J. Pappas , BrajeshK. Lal , Frank T. Padberg Jr. ,
Robert W. Zickler , and Walter N. Duran
9. Mechanism and E ects of Compression erapy 79
H u g o P a r t s c h
10. Classifying Venous Disease 86
B o E k l ö f
P A R T I I
PRIMARY SUPERFICIAL VENOUS
I N S U F F I C I E N C Y
11. Risk Factors, Manifestations, and Clinical Examination
of the Patient with Primary Venous Insu ciency 95
J o h n J . B e r g a n
12. Sclerosant Agents:Mechanisms of Action,
Classi cation, and Pharmacology 100
Attilio Cavezzi and Marcello Izzo
13. Sclerotherapy Treatment of Telangiectasias 109
Robert A. Weiss and Margaret A. Weiss
14. Complications of Liquid Sclerotherapy 115
Nisha Bunke-Paquette
15. Laser Treatment of Telangiectasias and Reticular Veins 127
Neil Sadick and Lian Sorhaindo
16. Overview:Treatment of Venous Insu ciency 136
J o h n J . B e r g a n
17. Ultrasound Examination of the Patient with Primary
Venous Insu ciency 140
Nicole Loerzel , Virginia Ratcli , Nisha Bunke-Paquette ,
and John J. Bergan
18. Sclerotherapy and Ultrasound-Guided Sclerotherapy 149
P a u l K . ibault
19. Sclerofoam for Treatment of Varicose Veins 159
J e a n - J é r ô m e G u e x
20. Sclerosants in Microfoam:ANew Approach
in Angiology 166
Juan Cabrera , Maria V. Rubia , and Juan Cabrera Jr.
21. Ultrasound-Guided Catheter and Foam
erapy for Venous Insu ciency 175
Nisha Bunke-Paquette , Nicole Loerzel ,
and John J. Bergan
22. Principles of Treatment of Varicose Veins 183
S t e v e n E . Z i m m e t
23. Inversion Stripping of the Saphenous Vein 186
J o h n J . B e r g a n
24. Neovascularization:An Adverse Response
to Proper Groin Dissection 192
Marianne De Maeseneer
25. e Changing Importance of the Saphenous Vein:
Treating versus Nontreatment 199
Paul Pittaluga , S. Chastanet , and T. Locret
26. Principles of Ambulatory Phlebectomy 208
Jose I. Almeida and Je rey K. Raines
v

27. Transilluminated Powered Phlebectomy 217
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Nick Morrison
28. Laser and Radiofrequency Ablation 220
Nick Morrison
29. Treatment of Small Saphenous Vein Re ux 227
Kenneth Myers , Amy Clough , Stefania Roberts ,
and Damien Jolley
30. Classi cation and Treatment of Recurrent
Varicose Veins 236
Michel Perrin
31. Use of System-Speci c uestionnaires 247
A. C. Shepherd , Meryl Davis , and Alun H. Davies
32. Pelvic Congestion Syndrome: Diagnosis
and Treatment 252
G ra e m e D . R i c h a r d s o n
P A R T I I I
V E N O U S T H R O M B O E M B O L I S M
33. e Epidemiology of Venous romboembolism
in the Community:Implications for Prevention
and Management 261
J o h n A . H e i t
34. Fundamental Mechanisms in Venous rombosis 268
Jose A. Diaz , Daniel D. Myers Jr.,
and o m a s W. Wa k e e l d
35. Congenital and Acquired Hypercoagulable
Syndromes 276
Jocelyn A. Segall and Timothy K. Liem
36. New Ways to Prevent Venous romboembolism:
Inhibition of Factor Xa and rombin 284
David Bergqvist
37. Diagnosis of Deep Venous rombosis 289
David A. Frankel and Warner P. Bundens
38. rombotic Risk Assessment:AHybrid Approach 295
Joseph A. Caprini
39. Venous romboembolism Prophylaxis in the
General Surgical Patient 306
J. I. Arcelus and J. A. Caprini
40. Conventional Treatment of Deep Venous rombosis 318
Graham F. Pineo and Russell D. Hull
41. Diagnosis and Management of Heparin-Induced
rombocytopenia 332
eodore E. Warkentin
42. Operative Venous r o m b e c t o my 340
Anthony J. Comerota and Steven S. Gale
43. Permanent Vena Cava Filters:Indications, Filter
Types, and Results 351
Ali F. AbuRahma and Patrick A. Stone
44. Complications of Vena Cava Filters 367
Teresa L. Carman and Linda M. Graham
45. Temporary Filters and Prophylactic Indications 378
Robert B. Rutherford , John C. McCallum ,
and Nikhil Kansal
46. rombolytic erapy for Acute Venous rombosis 387
Anthony J. Comerota and Santiago Chahwan
47. Percutaneous Mechanical rombectomy in the
Treatment of DVT 397
Colleen M. Johnson , Pritham P. Reddy ,
and Robert B. Mcla e r t y
48. Diagnosis and Management of Primary
Axillosubclavian Venous rombosis 408
Niren Angle
49. Subclavian Vein Obstruction:Techniques for
Repair and Bypass 414
Richard J. Sanders
50. Super cial rombophlebitis:Recommendations
for Diagnosis and Management 419
J o a n n M . L o h r
P A R T I V
C H R O N I C V E N O U S I N S U F F I C I E N C Y
51. e Primary Cause of Chronic Venous Insu ciency 431
Michel Perrin and Oscar Maleti
52. Conventional Surgery for Chronic Venous
Insu ciency 440
William Marston
53. Subfascial Endoscopic Perforator Vein Surgery (SEPS)
for Chronic Venous Insu ciency 451
Peter Gloviczki , Manju Kalra ,
and Alessandra Puggioni
54. Ultrasound-Guided Sclerotherapy of Perforating
Veins in Chronic Insu ciency 457
Fedor Lurie , Alessandra Puggioni , and Robert L. Kistner
55. Perforating Veins 463
John J. Bergan , Luigi Pascarella ,
and Nisha Bunke-Paquette
56. Endovascular Management of Iliocaval rombosis 468
Patricia E. orpe and Francisco J. Osse
57. Popliteal Vein Entrapment 482
S e s h a d r i R a j u
vi • CONTENTS

58. Valvuloplasty in Primary Venous Insu ciency:
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Development, Performance, and Long-Term Results 486
Robert L. Kistner , Elna Masuda ,
and Fedor Lurie
59. Prosthetic Venous Valves 499
Michael C. Dalsing
60. Postthrombotic Syndrome:Clinical Features,
Pathology, and Treatment 505
S e s h a d r i R a j u
61. E cacy of Veno-Active Drugs in Primary Chronic
Venous Disease Survey of Evidence, Synthesis,
and Tentative Recommendations 514
Michel Perrin and Albert-Adrien Ramelet
62. Medical Management of the Venous Leg Ulcer:
Wound Dressings and Adjuvant Agents 528
Nisha Bunke-Paquette , Teresa Russell, Kevin Broder ,
and Andrew Li ,
P A R T V
CONGENITAL VENOUS ABNORMALITIES
63. Venous Malformations and Tumors:Etiology,
Diagnosis, and Management 541
B.B. Lee and James Laredo
Index 549
CONTENTS • vii

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C O N T R I B U T I N G A U T H O R L I S T
https://t.me/med1917
A l i F. A b u R a h m a
Robert C. Byrd Health SciencesCenter
West Virginia University
Charleston,WV
Claudio Allegra
University La Sapienza
Rome,Italy
Jose I. Almeida
Miami VeinCenter
Miami,FL
NirenAngle
University of California, San Diego HealthSystem
San Diego,CA
J. I. Arcelus
Hospital Virgen de lasNieves
University of Granada
Granada,Spain
J o h n J . B e r g a n
University of California, SanDiego
La Jolla,CA
David Bergqvist
Uppsala University Hospital
Uppsala,Sweden
J u a n C a b r e r a
Instituto Internacional de Flebologia
Barcelona,Spain
Juan Cabrera Jr.
University Clinic of Navarra
Granada,Spain
Alberto Caggiati
University La Sapienza
Rome,Italy
J o s e p h A . C a p r i n i
Evanston Northwestern Healthcare
Evanston,IL
Teresa L. Carman
University Hospitals Case MedicalCenter
Case Western Reserve University School of Medicine
Cleveland,OH
Attilio Cavezzi
Clinic StellaMaris
Tronto,Italy
Santiago Chahwan
Jobst VascularCenter
e Toledo Hospital
Toledo,OH
K e v i n B r o d e r
University of California, San Diego Health Systems
VA San Diego HealthcareSystem
La Jolla,CA
Wa r n e r P . B u n d en s
VA San Diego HealthcareSystem
La Jolla,CA
Nisha Bunke-Paquette
La Jolla VeinCare
VA San Diego HealthcareSystem
La Jolla,CA
S. Chastanet
Riviera Vein Institute
Nice,France
Amy Clough
Melbourne Vascular Ultrasound
Melbourne, Australia
Anthony J. Comerota
Jobst VascularCenter
e Toledo Hospital
Toledo,OH
ix
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