The VEIN Handbook
|Frequently Asked Questions Index|
Chapter 1: Normal Venous Circulation
" What is the main function of the deep venous circulation?
" What characteristics do veins have that enable them to return blood to the heart?
" At what three sites does a peripheral pump mechanism contribute to the return flow of blood from the
extremity toward the heart? Which is the main contributor?
" How much of the blood contained within the deep veins of the calf is expelled by calf contraction?
Chapter 2: Acute Deep Venous Thrombosis and Its Complications
" What is deep venous thrombosis?
" What causes a deep venous thrombosis?
• What is deep venous thrombosis?
• What are the major complications of deep venous thrombosis?
• How is a deep venous thrombosis treated?
Chapter 3: Hypercoagulable States in Venous Disease
• What is a hypercoagulable state?
" What is heparin-induced thrombocytopenia?
• What is factor V Leiden (or activated protein C deficiency)?
• What is hyperhomocysteinemia?
• What is protein C deficiency?
Chapter 4: Medical Treatment of Acute Deep Venous Thrombosis
• What is deep venous thrombosis (DVT)?
• Why is my doctor concerned with the occurrence of DVT?
• What is the usual treatment for DVT?
• What are the possible risks of taking anticoagulants for the treatment of DVT?
• How is treatment for DVT with low molecualr weight heparin different from the more familiar
Chapter 5: Catheter-directed Thrombolysis for Acute Deep Venous Thrombosis
• What is thrombolysis?FAQs\hbk05q.html
• Which patients derive the most benefit from catheter-directed thrombolysis?
• What are the objectives of thrombolysis?
• Are there other benefits of catheter-directed thrombolysis?
• What are the complications of thrombolysis?
• Are there alternatives to catheter-directed thrombolysis for extensive venous thrombosis?
Chapter 6: Surgery for Acute Iliofemoral Deep Venous Thrombosis
• What are the symptoms of acute iliofemoral deep vein thrombosis?
• Which is the most important objective when treating iliofemoral deep vein thrombosis?
• What is the first choice for the treatment of iliofemoral deep vein thrombosis?
• Why is a venous thrombectomy performed after a deep vein clot has been discovered?
• Why is an arteriovenous fistula created after a vein thrombectomy is performed?
• Are long-term results after thrombectomy better than that obtained with anticoagulation use alone?
Chapter 7: Superficial Venous Thrombophlebitis
• What is superficial thrombophlebitis?
• What is the usual treatment for superficial thrombophlebitis caused by a minor trauma?
• Can superficial thrombophlebitis lead to deep venous thrombosis and its potential health risks?
• How do I know that I have a superficial thrombophlebitis?
• I have had a hard and tender knot appear in my arm where an IV had been in place and used to put me
asleep for a minor surgery. Is this something to worry about?
Chapter 8: Treatment of Acute Axillary-Subclavian Venous Thrombosis
• I was building my weightlifting repetitions over the weekend and woke up with a swollen and painful
right arm. It has not resolved with rest; what should I do?
• What are the risks of ignoring the symptoms of effort vein thrombosis?
• What is needed to confirm that I do or do not have a clot in my upper arm and shoulder veins?
• What needs to be done to minimize the problems that can be associated with upper arm deep vein
• I am an active construction worker and have just experienced a clot of my right arm deep shoulder veins.
If simple anticoagulation may not provide me with full arm function within a short period of time, what
might be needed?
Chapter 9: Pulmonary Embolism
• What is a pulmonary embolism?
• How serious is a pulmonary embolism?
• Who is likely to have a pulmonary embolism?
• How can I protect myself against a pulmonary embolism?
• How will I know if I have a pulmonary embolism?
Chapter 10: Prevention of Deep Venous Thrombosis
• My doctor has recommended intermittent external pneumatic leg compression as a preventive measure
for deep vein thrombosis. How does this work?
• Why is my doctor so concerned about preventing clots from developing in my deep leg veins during my
• What methods are available to prevent deep leg vein clots from occurring during my planned cancer
• I am going to have my hip replaced next week. I know that cancer increases the chances of clot formation
in my legs during an operation, but does this non-cancer operation hold the same risk?
• I am a healthy 55-year-old man who needs an operation for gastroesophageal reflux due to unrelenting
heartburn symptoms. What are my options for preventing deep venous thrombosis during my operation?
Chapter 11: Indications and Techniques of Inferior Vena Cava Interruption
• Will I be able to feel the filter or tell that I have it?
• Does the filter ever have to be changed?
• Do I need to avoid sports or change my usual activities because of the filter?
• Will I need to take anticoagulants for life?
• Can I still have an MRI scan with a filter?
Chapter 12: Sclerotherapy
• Is sclerotherapy the best treatment for large varicose veins (larger than 5 mm)?
• Can spider veins be treated by surgery?
• Are there any treatment methods for varicose veins other than sclerotherapy and surgery?
• Who should treat my varicose veins?
• What kind of elastic garments should I get?
Chapter 13: Complications of Sclerotherapy
• My doctor is considering sclerotherapy for the discolored, protruding veins in my leg. I have heard that
the veins or area around them may be a brownish rather than blue color after the injections. Is this
common and does it last forever?
• A friend has had multiple sclerotherapy injections for varicose veins with good results. However, the last
injection resulted in a small skin ulcer. Is this common, and what will be the long-term result?
• The agents used to inject veins during sclerotherapy are drugs, can one have an allergic reaction while
having these injections?
• During sclerotherapy, can the injected drug escape the superficial veins and cause damage or clots to
occur in my deep veins?
• Can my arteries be damaged during venous sclerotherapy injections for my varicose veins?
Chapter 14: Surgery for Varicose Veins
• I have had surgery for varicose veins, and I have a purple patch on my thigh. Will this go away?
• I have had vein surgery, and the entire inside of my leg is numb from nearly the knee to the ankle.
The surgery was done 10 days ago.
• I had vein surgery 15 years ago and I have most of my veins back. What do I do now?
• I have had large varicose veins for many years, and they do not bother me at all. Should anything be
done about them?
• I have varicose veins and I have had phlebitis in these veins several times. What can be done about
Chapter 15: Compression Treatment for Chronic Venous Insufficiency
• What causes chronic venous insufficiency?
• Can elastic stockings cut off the circulation to my legs?
• Once my ulcer is healed, why do I continue to need to wear elastic stockings?
• Can't I have an operation to correct my venous insufficiency and thereby avoid needing to use stockings?
• How do I know if my compression stockings are helping me?
Chapter 16: Surgical Repair of Incompetent Venous Valves
• What is venous insufficiency of the lower leg?
• My doctor tells me that I have primary deep venous insufficiency, which is causing the recurrent ulcer on
my leg. What does this mean?
• How can my doctor be sure that I have primary deep venous insufficiency causing the recurrent ulcer on
• Is the only treatment for primary deep venous insufficiency compression stockings and elevation of my
• Who is a candidate for surgical treatment of primary deep venous insufficiency?
Chapter 17: Venous Valve Transplantation and Vein Segment Transfer for Valvular Incompetence of Deep Veins
• How long will I be out of work after a reconstruction of the deep veins of my leg?
• Will my arm swell on the side where a vein valve was removed to donate to the leg?
• Will I be required to do anything else after surgery?
• Besides promoting ulcer healing and preventing its recurrence, will the skin and fatty tissue of my
affected leg improve?
• What is the chance that I will require another deep venous transplantation or transposition operation in
the next 2-3 years?
Chapter 18: Endovascular Reconstruction for Chronic Iliac Vein and Inferior Vena Cava Obstruction
• I have swelling and discomfort in my left leg when I exercise. My doctor says I have the May-Thurner
syndrome. What is this syndrome?
• What can be done to relieve my symptoms associated with the May-Thurner syndrome?
• Can a totally occluded iliac vein or inferior vena cava (the large abdominal vein that directs all lower body
blood back to the heart) be reopened?
• What complications can occur when trying to open an occluded vein by minimally invasive methods?
Chapter 19: Subfascial Endoscopic Perforating Vein Surgery
• Where are the important perforating veins located?
• What is the cause of perforator incompetence?
• What is the best test to confirm incompetent perforators?
• What is the best surgical technique to interrupt incompetent perforators?
• What can you expect after the SEPS procedure?
Chapter 20: Lymphedema
• Does the lymphatic system transport blood back to the heart?
• Does lymphedema involve the accumulation of blood in the extremities?
• How is lymphedema diagnosed?
• I have been diagnosed with lymphedema. What is the treatment for it?
• Can lymphedema be prevented?
Chapter 21: Treatment of Lymphedema
• I have swelling in my leg that even involves my foot; it appeared without an apparent cause. My doctor
has told me that I have primary lymphedema since no other cause can be found. What other problems
could cause leg swelling?
• Is there a cure for primary lymphedema?
• How can I decrease the unsightly leg swelling associated with lymphedema?
• What can be used to keep the swelling (lymphedema) from coming back in my legs?
• Do I have other health risks I should know about because of my chronic lymphedema?
Read Chapter 1: Normal Venous Circulation