New approaches to the diagnosis and treatment of venous obstruction

Diagnosis of chronic venous obstruction has hitherto depended on phlebographic assessment alone. The pitfalls in this method are noted and two simple hemodynamic techniques for measurement of venous obstruction are described. The techniques are easily performed, have a high degree of sensitivity and specificity, and are particularly useful in assessing various therapeutic approaches to venous obstruction. Our experience with a variety of surgical procedures for venous obstruction is described. Two such new procedures, primary arteriovenous fistula and perforator bypass for peripheral venous obstruction, are described in detail.