When is surgery indicated for the treatment of deep venous insufficiency?

Updated: Oct 22, 2018
  • Author: Robert Weiss, MD; Chief Editor: William D James, MD  more...
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Answer

The decision to operate on a patient with venous obstruction in the deep veins should be made only after a careful assessment of symptom severity and direct measurement of both arm and foot venous pressures. Venography alone is not sufficient, because many patients with occlusive disease have extensive collateral circulation, which renders them less symptomatic. Clot lysis (eg, with tissue plasminogen activator [TPA] or urokinase) and thrombectomy have been tried but have largely been abandoned because of extremely high recurrence rates.


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