A Treatise on Venous Diseases

by Radhakrishnan N, K A Vishnu Narayanan, A Abhinay

The veins remain always neglected in medical history. This is the very reason for the poor outcome following the treatment of the diseases related to veins. From 3500 BC until this day, the results following treatment of venous diseases are not promising. Patients are never satisfied even with any of the newer modalities of treatment currently available. Chronic Venous Disease is a vexing problem and it remains an unsolved enigma. The disease can manifest from birth up to any age. It can occur from head to foot, externally or internally. The commonest external manifestation is varicose veins of the lower limb and the most common internal manifestation is Piles (Hemorrhoids). Congenital malformations are also not too uncommon. Deep Vein Thrombosis (DVT) and subsequent venous thromboembolism are very grave and fatal and requires early diagnosis and prompt treatment. Congenital malformations of the veins, varicose veins of the lower limbs, and DVT are mainly discussed in this book. The role of the lymphatic system in the development of CVD is usually ignored. Its importance in the formation of chronic venous ulceration is hence well explained. +Our knowledge about the veins and its functioning is not yet well assessed. It remains a neglected topic even through the ages. A proper understanding about the venous system is very important. A detailed study of the anatomy, physiology, biophysics and microcirculation, which helps in tissue fluid formation, will help one to understand the etiopathogenesis of the venous diseases. The importance of genetic study with genomic analysis will help the future generation to escape from this dreadful disease. A new outlook based on the importance of the smallest veins (tributaries) and venules at the lower most level of leg in the pathogenicity of CVD is explained in a separate chapter. The meaningless ultrasonological assessment of perforators and major junctional refluxes traditionally followed and the surgical interventions planned and carried out in patients, contrary to the physical and physiological norms will create more problems to such patients in due course. A new physiologic and logical innovation in technique will help the reader to achieve better dimensions to offer promising results to the already suffering patients after repeated contemporary surgical interventions. However, for description sake, the standard open surgical procedures and the non-invasive procedures are also included. At the end of the book, photographic representations based on CEAP Classification, the results of sclerotherapy, in CVD and Congenital malformations treated with microfoam sclerotherapy are also given.

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