Abstract
The most common cause of chronic venous disease (CVD) is reflux. Reflux is abnormal blood flow direction resulting from venous valve dysfunction. In the lower extremity thigh and calf, abnormal flow is from proximal to distal in deep or superficial veins, or deep to superficial in perforator veins. Reflux is most often primary (unknown etiology and not present at birth), is less often secondary (known cause like thrombosis or trauma), and is rarely congenital. This chapter will discuss how to manage symptomatic venous reflux disease.
This is a preview of subscription content, log in via an institution to check access.
Access this chapter
Tax calculation will be finalised at checkout
Purchases are for personal use only
References
Gloviczki P, Comerota A, Dalsing M, Eklof B, Gillespie D, Gloviczki M, Lohr J, McLafferty R, Meissner M, Murad M, Padberg F, Pappas P, Passman M, Raffetto J, Vasquez M, Wakefield T. The care of patients with varicose veins and associated chronic venous diseases: clinical practice guidelines of the Society for Vascular Surgery and the American Venous Forum. J Vasc Surg. 2011;53:2S–48.
Miller DR, Enoch S, Williams DT, Price PE, Harding KG. Value of wound biopsy in chronic venous ulceration. Phlebology. 2004;19:65–8.
Labropoulos N. Clinical correlation to various patterns of reflux. Vasc Endovascular Surg. 1997;31:242–8.
Obermayer A, Garzon K. Identifying the source of superficial reflux in venous leg ulcers using duplex ultrasound. J Vasc Surg. 2010;52:1255–61.
Labropoulos N, Tiongson J, Pryor L, Tassiopoulo AK, Kang SS, Mansour MA, Baker WH. Nonsaphenous superficial vein reflux. J Vasc Surg. 2001;34:872–7.
Palfreyman SJ, Michaels JA. A systematic review of compression hosiery for uncomplicated varicose veins. Phlebology. 2009;24 Suppl 1:13–33.
Motykie GD, Caprini JA, Arcelus JI, Reyna JJ, Overom E, Mokhtee D, et al. Evaluation of therapeutic compression stockings in the treatment of chronic venous insufficiency. Dermatol Surg. 1999;25:116–20.
Michaels JA, Campbell WB, Brazier JE, Macintyre JB, Palfreyman SJ, Ratcliffe J, et al. Randomized clinical trial, observational study and assessment of cost effectiveness of the treatment of varicose veins (REACTIV trial). Health Technol Assess. 2006;10:1–196.
Padberg FT, Johnston MV, Sisto SA. Structured exercise improves calf muscle pump function in chronic venous insufficiency: a randomized trial. J Vasc Surg. 2004;39:79–87.
Mowatt-Larssen E, Shortell C. Truncal vein ablation for laser: radial firing at high wavelength is the key? J Vasc Endovasc Surg. 2010;17:217–23.
Barwell JR, Davies CE, Deacon J, Harvey K, Minor J, Sassano A, et al. Comparison of surgery and compression with compression alone in chronic venous ulceration (ESCHAR study): randomized controlled trial. Lancet. 2004;363:1854–9.
Zamboni P, Cisno C, Marchetti F, Mazza P, Fogato L, Carandina S, De Palma M, Liboni A. Minimally invasive surgical management of primary venous ulcers vs compression treatment: a randomized clinical trial. Eur J Vasc Endovasc Surg. 2003;25:313–8.
O’Donnell TF. The present status of surgery of the superficial venous system in the management of venous ulcer and the evidence for the role of perforator interruption. J Vasc Surg. 2008;48:1044–52.
Cockett FB, Jones DE. The ankle blow-out syndrome: a new approach to the varicose ulcer problem. Lancet. 1953;1:17–23.
Labropoulos N, Volteas N, Leon M, Sowade O, Rulo A, Giannoukas AD, Nicolaides AN. The role of venous outflow obstruction in patients with chronic venous dysfunction. Arch Surg. 1997;132:46–51.
Carradice D, Mekako AI, Hatfield J, Chetter IC. Randomized clinical trial of concomitant or sequential phlebectomy after endovenous laser therapy for varicose veins. Br J Surg. 2009;96:369–75.
Monahan D. Can phlebectomy be deferred in the treatment of varicose veins? J Vasc Surg. 2005;42:1145–9.
Markovic J, Shortell C. Endovenous laser ablation: strategies for treating multilevel disease. Perspect Vasc Surg Endovasc Ther. 2009;21:73–81.
Mowatt-Larssen E. Management of secondary varicosities. Semin Vasc Surg. 2010;23:107–12.
Vasquez MA, Wang J, Mahathanaruk M, Buczkowski G, Sprehe E, Dosluoglu HH. The utility of the Venous Clinical Severity Score in 682 limbs treated by radiofrequency saphenous vein ablation. J Vasc Surg. 2007;45:1008–15.
Bernardini EB, De Rango P, Piccioli R, et al. Development of primary superficial venous insufficiency: the ascending theory. Observational and hemodynamic data from a 9-year experience. Ann Vasc Surg. 2010;24:709–20.
Pittaluga P, Chastanet S, Rea B, Barbe R. Midterm results of the surgical treatment of varices by phlebectomy with conservation of a refluxing saphenous vein. J Vasc Surg. 2009;50:107–18.
Mowatt-Larssen E, Shortell C. CHIVA. Semin Vasc Surg. 2010;23:118–22.
Franceschi C, Zamboni P. Principles of venous hemodynamics. New York: Nova Biomedical Books; 2009.
Carandina S, Mari C, De Palma M, Marcellino MG, Cisno C, Legnaro A, Liboni A, Zamboni P. Varicose vein stripping vs haemodynamic correction (CHIVA): a long term randomised trial. Eur J Vasc Endovasc Surg. 2008;35:230–7.
Pares JO, Juan J, Tellez R, et al. Stripping versus the CHIVA method: a randomized, controlled trial. Ann Surg. 2010;251:624–31.
Author information
Authors and Affiliations
Corresponding author
Editor information
Editors and Affiliations
Rights and permissions
Copyright information
© 2014 Springer International Publishing Switzerland
About this chapter
Cite this chapter
Geersen, D.F., Mowatt-Larssen, E. (2014). Reflux Management. In: Mowatt-Larssen, E., Desai, S., Dua, A., Shortell, C. (eds) Phlebology, Vein Surgery and Ultrasonography. Springer, Cham. https://doi.org/10.1007/978-3-319-01812-6_4
Download citation
DOI: https://doi.org/10.1007/978-3-319-01812-6_4
Published:
Publisher Name: Springer, Cham
Print ISBN: 978-3-319-01811-9
Online ISBN: 978-3-319-01812-6
eBook Packages: MedicineMedicine (R0)