Deep Venous Disease: Valve Limits, Stenting, And Pump Physiology
Valve Reconstruction Versus Obstruction Correction
A masterclass argues correcting venous obstruction with stenting produces stable, durable results, while deep valve reconstruction shows steady loss of competence over ten years and high ulcer recurrence. Basic science studies describe a sirolimus-coated balloon that reduces venous wall fibrosis and identify a PAI-1 protein domain that drives vein wall thickening after thrombosis, offering potential future targets.
Rethinking Calf Pump Physiology
A physiologic study using simultaneous pressure measurements found that during exercise, flow reverses from superficial into deep veins through thigh and calf perforators, challenging older models of muscle pump function and foot vein pressure as a proxy for deep venous pressure.
Iliac Disease: Sizing, Detection, And A Novel Bypass
Longer fasting before venography was associated with smaller iliac stents, and suprainguinal iliac disease was found in nearly two-thirds of venous ulcer patients using full-length imaging, roughly double prior estimates. A novel surgical anteriorization technique offers an alternative to stenting for May-Thurner patients with nickel allergies.
