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Treatment of lower limb and pelvic deep vein incompetence 

Treatment of lower limb and pelvic deep vein incompetence
Chapter:
Treatment of lower limb and pelvic deep vein incompetence
Author(s):

Cees Wittens

and Mark de Wolf

DOI:
10.1093/med/9780199658220.003.0073
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date: 17 September 2019

Venous insufficiency is caused by a failure of the venous valves to prevent retrograde flow, leading to venous hypertension. Venous hypertension is associated with symptoms of varicose enlargement of vessels, skin changes in the lower extremity, and local pain in the leg or the pelvic area. Most patients suffering from lower limb deep venous insufficiency can be adequately treated by conservative measures. In a minority of cases deep venous surgery is indicated. Surgical interventions include internal and external valvuloplasty, transposition of the femoral vein, transplantation of autologous valve-bearing vein segments to the lower limb, and neo-valve creation. In case of varicoceles in male patients surgical treatment by the urologist offers the best results. Endovenous stenting is the preferred method of treatment in case of Nutcracker or May Thurner syndrome. All these interventions are generally offered only in specialized tertiary medical centers with an interest in deep venous surgery.

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