Distribution and clinical impact of phlebosclerosis

Sclerosis of the vessels has been extensively described in arteries but rarely in veins. Phlebosclerosis refers to the thickening and hardening of the venous wall. Despite its morphological similarities with arteriosclerosis and potential morbid consequences phlebosclerosis has gained only little attention. This is a narrative review based on a MEDLINE search (1949 to February 2009) of articles in English, German and Japanese (with English abstracts). References in retrieved articles were searched for further potentially relevant articles. Controversy about the definition, etiology, pathogenesis and histological aspects of phlebosclerosis exists. Phlebosclerosis constitutes a fibrous degeneration of the venous wall, predominantly the intima, with or without calcification. It has been described to affect almost the entire venous system with variable clinical consequences. The exact pathophysiologic mechanisms are unknown. Despite the confusing terminology and limited scientific data, we conclude that phlebosclerosis should be regarded as a distinct clinical entity. Its prevalence and clinical significance may be underestimated. Future research towards the better definition of the term and recognition of its true prevalence, distribution and clinical significance is warranted.