Conventional management targeted at reducing reflux has been surgical removal of the great saphenous vein (GSV) from the level of the saphenofemoral junction to the level of the knee or ankle (along with saphenous vein branch ligation in the groin). Alternatives to saphenous vein stripping and ligation include vein ablation using laser energy, radiofrequency-generated thermal energy, or chemical sclerosing agents [6-8]. Discussion of Procedures by Variant Variant 1: Varicose veins. Initial diagnosis. Catheter Venography Iliac Veins Catheter venography of the iliac veins can aid in evaluating proximal occlusions or significant stenosis when proximal varicosities are present. Adjunctive usage of intravascular ultrasound (IVUS) can improve the specificity aModern Vascular of Denver, Thornton, Colorado. bResearch Author, University of Colorado Denver, Denver, Colorado. cPanel Chair, University of Michigan, Ann Arbor, Michigan. dPanel Chair, Massachusetts General Hospital, Boston, Massachusetts. ePanel Vice-Chair, University of California San Francisco, San Francisco, California. fPanel Vice-Chair, University of Vermont Medical Center, Burlington, Vermont. gDetroit Medical Center, Tenet Healthcare and Envision Radiology Physician Services, Detroit, Michigan. hZucker School of Medicine at Hofstra Northwell, Hempstead, New York. iTufts University School of Medicine, Boston, Massachusetts; Society for Vascular Surgery. jOregon Health and Science University, Portland, Oregon. kMedical University of South Carolina, Charleston, South Carolina. lRenaissance School of Medicine at Stony Brook University, Stony Brook, New York. mBoston University School of Medicine, Boston, Massachusetts. nMayo Clinic, Rochester, Minnesota; Commission on Nuclear Medicine and Molecular Imaging. oWeill Cornell Medicine- New York Presbyterian Hospital, New York, New York; American Vein & Lymphatic Society. pFroedtert & The Medical College of Wisconsin, Milwaukee, Wisconsin.
Lower Extremity Chronic Venous Disease. Conventional management targeted at reducing reflux has been surgical removal of the great saphenous vein (GSV) from the level of the saphenofemoral junction to the level of the knee or ankle (along with saphenous vein branch ligation in the groin). Alternatives to saphenous vein stripping and ligation include vein ablation using laser energy, radiofrequency-generated thermal energy, or chemical sclerosing agents [6-8]. Discussion of Procedures by Variant Variant 1: Varicose veins. Initial diagnosis. Catheter Venography Iliac Veins Catheter venography of the iliac veins can aid in evaluating proximal occlusions or significant stenosis when proximal varicosities are present. Adjunctive usage of intravascular ultrasound (IVUS) can improve the specificity aModern Vascular of Denver, Thornton, Colorado. bResearch Author, University of Colorado Denver, Denver, Colorado. cPanel Chair, University of Michigan, Ann Arbor, Michigan. dPanel Chair, Massachusetts General Hospital, Boston, Massachusetts. ePanel Vice-Chair, University of California San Francisco, San Francisco, California. fPanel Vice-Chair, University of Vermont Medical Center, Burlington, Vermont. gDetroit Medical Center, Tenet Healthcare and Envision Radiology Physician Services, Detroit, Michigan. hZucker School of Medicine at Hofstra Northwell, Hempstead, New York. iTufts University School of Medicine, Boston, Massachusetts; Society for Vascular Surgery. jOregon Health and Science University, Portland, Oregon. kMedical University of South Carolina, Charleston, South Carolina. lRenaissance School of Medicine at Stony Brook University, Stony Brook, New York. mBoston University School of Medicine, Boston, Massachusetts. nMayo Clinic, Rochester, Minnesota; Commission on Nuclear Medicine and Molecular Imaging. oWeill Cornell Medicine- New York Presbyterian Hospital, New York, New York; American Vein & Lymphatic Society. pFroedtert & The Medical College of Wisconsin, Milwaukee, Wisconsin.