Table of Contents

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The Vein Book – Third Edition
 

Section I: Foundations of Venous and Lymphatic Medicine

1. Historical Perspective of Venous and Lymphatic Medicine
2. Venous Embryology and Anatomy
   • Embryology
     • Chest, Abdomen, and Pelvis
     • Lower Extremity (with Arterial and Neural Embryology)
   • Anatomy
     • Abdomen and Pelvis
     • Lower Extremity (with Arterial and Neural Embryology)

3. Venous Physiology and Pathophysiology

• Lower Extremity Venous Hemodynamics
• Macrocirculation pathophysiology:
  • Primary Superficial Insufficiency, Varicose Veins, and Valve Dysfunction
  • Secondary Venous Disease (Post-Thrombotic Reflux and Obstruction)
  • Primary Deep Vein Reflux
• Microcirculation physiology and pathophysiology: Understanding Skin Damage and Ulceration

1. Functional Venous Insufficiency
   • Obesity and Venous Disease
   • Gait Disorders and Venous Insufficiency

1. Genetics of Chronic Venous Insufficiency
2. Epidemiology of Chronic Venous Disease
   • San Diego, Framingham, Edinburgh, and Bonn Vein Studies

1. Classification of Venous Disease and Clinical Assessment
   • Clinical Tools: rCEAP, rVCSS, PROMs 
   • Definitions: Venous reflux, obstruction and Chronic Venous Insufficiency

1. Cutaneous Manifestations of Venous Disease: Clinical Considerations and Atlas
2. Compression Therapy
   • Devices in Use (GCS, Bandaging,  Wraps, Pneumatic and Novel Products)
   • Mechanism of Action
   • Clinical Applications Overview

1. Venoactive Medications in Chronic Venous and Lymphatic Disease

• Agents in Use
• Mechanism of Action
• Clinical Applications Overview

1. Sclerosing Agents

• Agents in Use
• Mechanism of Action
• Clinical Applications Overview

1. Hematology for the Venous and Lymphatic Specialist

• Coagulation Cascade in Health and Disease
  • Hypercoagulable Syndromes (Congenital and Acquired)
• Anticoagulants and Antiplatelet Therapies
• Thrombolytic Agents
• Special Populations: Pediatric, Pregnancy, and Oncologic Patients
• Special Considerations: Thrombotic Risk Assessment and Prophylaxis with Vein Treatment

Section II: Diagnostic Modalities

1. Principles of Venous Ultrasound
2. Techniques, Standards, and Protocols for Venous Ultrasound 
   1. Lower Extremities
   2. Abdomen, Pelvis
3. Venography: 
   1. Lower Limb, 
   2. Abdomen and Pelvis
   3. Upper extremity and chest
4. Intravascular Ultrasound (IVUS) Venous Disease

Section III: Interventional Techniques

1. Tools and Techniques for Venous Access

• Cannulation Needles, Wires, Sheaths, Catheters

1. Ultrasound-Guided Cannulation

• Transverse and Longitudinal      Techniques, Beam Path, Cannulation Angle

1. Light-Based Therapies for C1 Disease
2. Sclerotherapy for C1-C6

• Visual Sclerotherapy
• Ultrasound-Guided Sclerotherapy
• Management of Trapped Blood

1. Tumescent Anesthesia
2. Micro-Stab Phlebectomy
3. Thermal Ablation of Saphenous Veins (RF, Laser)
4. Non-Thermal Ablation of Saphenous Veins (MOCA, Glue, Foam)
5. Saphenous sparing hemodynamic strategies: 
   1. CHIVA
   2. ASVAL
6. Venous Stenting
7. Systemic thrombolysis
8. Venous Thrombectomy and Catheter Based Thrombolysis 
9. IVC Filters

• Indications
• Devices and Their Use
• Removal

1. Prosthetic Valves and Valvuloplasty
2. Less Used Surgical Approaches

• Saphenous Ligation and Stripping
• Palma Procedure
• May-Husni Procedure

Section IV: Venous Compressive Disorders

1. Overview of Venous Compressive Disorders

• For each section:
  • Definition and Pathophysiology
  • Common Clinical Presentations

1. Iliac Vein Compression (NIVL, Previously May-Thurner Syndrome)
   1. Briefer conversation here as this will be covered in more detail later)
2. Left Renal Vein Compression (Previously Nutcracker Syndrome)
3. Thoracic Outlet Syndrome (With and Without Thrombosis)
4. Popliteal Entrapment Syndrome
5. Other Considerations: Popliteal  Aneurysm

Section V: Clinical Management of Thromboembolic Disease

1. Superficial Venous Thrombosis (SVT)
2. Acute Distal Lower Extremity Deep Vein Thrombosis (DVT)
   1. Tibial
   2. Muscular
3. Acute Proximal non-iliofemoral  or caval DVT
   1. Thrombosis involving the popliteal and femoral veins
4. Acute Iliofemoral and/or IVC DVT
5. Lower Extremity Post-Thrombotic Sequelae
6. Acute Pulmonary Embolism and its potential chronic consequences
7. Upper Extremity and SVC Acute DVT

Section VI: Clinical Management of Chronic Venous Disorders

1. Overview: Indications, Techniques, Outcomes, and Complications
2. Superficial Venous Disease Management (C1-C2)
   1. Telangiectasia and reticular vein abnormalities (C1)
   2. Varicose veins
      1. Non-saphenous varicose veins
      2. Saphenous tributary varicose veins
3. Venous Leg Ulcer Management (C5-C6 Disease)

• Venous Ulcer Care
• Principles
• Techniques
  • Compression Therapy
  • Wound Care
  • Peri-ulcer Skin Care
  • Skin grafts  and substitutes
• Superficial Venous Management
• Deep Venous Disease Management
  • Post thrombotic obstruction
    • Sura inguinal
    • Infra inguinal
  • NIVL
  • Infra inguinal Reflux

1. Special Considerations: C4 Venous Skin Disease
2. Special Considerations: Isolated C3 Venous Swelling
   1. Include the differential diagnosis of lower limb swelling and when the clinical context suggests a venous etiology
3. Special Considerations: Perforator Vein Disease
4. Special Considerations: Persistent swelling post stenting

Section VII: Clinical Management of Pelvic Vein Disorders

1. Overview: Nomenclature,Pathophysiology, and Classification
2. Pelvic Pain Generators in Women
3. Venous-Origin Chronic Pelvic Pain in Women
   1. Primary reflux
   2. NIVL related
   3. Special consideration: co-existent primary reflux and NIVL
4. Lower Extremity Varicose Veins of Pelvic Origin in Women
5. Vulvar Varicose Veins
6. Male Pelvic Venous Disorders

Section VIII: Venous Malformations

1. General Overview: Historical Background
2. Definition and Classification (ISSVA, Hamburg, Angiographic)
3. Etiopathogenesis: Coagulation Issues
4. Etiopathogenesis: Genetic Issues
5. Contemporary Diagnosis and  Management
6. Differential Diagnosis: Hemangioma
7. Extratruncular Lesions: Management and Complications
8. Truncular Lesions: IVC and Iliac-Femoral Vein Dysplasia
9. Special Issues 
   • Vascular Bone Syndrome
   • Klippel-Trenaunay Syndrome
   • Marginal Vein
   • Biologics and Repurposed Anti-Cancer Drugs in Malformation Treatment
   • Multidisciplinary Team Approach

Section IX: Lymphedema

1. General Overview
2. Lymphatic Embryology and Anatomy
3. Etiopathogenesis (Primary and Secondary)
4. Physiology (Phleboedema and Lymphedema)
   • Lymphatic Physiology and Pathophysiology: Understanding swelling

1. Clinical Diagnosis and Management      
   • Primary Lymphedema
     1. Genetic causes
     2. Idiopathic
   • Secondary Lymphedema
     1. Phlebolymphedema
     2. Obesity
     3. Iatrogenic
     4. Other
   • Clinical classification of lymphedema

1. Treatment of lymphedema
   • MLD
   • Compression
   • Exercise
   • Skin care

69. Truncular lesions: IVC & Iliac-Femoral Vein dysplasia   

1. Extratruncular Lesions- Management and Their Complication Translational Medicine in Phlebolymphedema
2. Special Issues 
   • Recalcitrant Stasis UlcernManagement
   • Lifestyle Considerations

Section X: Special Populations and Locations

1. Venous Disease During Pregnancy
2. Forehead and Periorbital Veins
3. Hand Veins

Section XI: Setting Up a Venous and Lymphatic Practice

1. Superficial Venous Practice
2. Deep Venous Practice 
   1. Hospital Based
   2. OBL/ASC
3. Lymphatic Practice
4. Vascular Malformations Practice
5. Facility Accreditation and  Provider Certification
6. Venous Registries: Value of Participation
7. Physician Extender Considerations