Deep Venous Reflux

  • Arjun Jayaraj


Chronic venous insufficiency (CVI) encompasses an extensive range of clinical manifestations from limb swelling to non-healing ulcers. Etiologies for CVI in the deep venous system include reflux, venous obstruction, or a combination of the two. Of these, reflux alone or in combination with obstruction is the contributing factor in the overwhelming majority (70–90%) of instances [1–7]. Such reflux involving the deep vein (DVR) can result from primary or secondary etiologies. The occurrence of DVR varies in different populations. While the precise number is hard to determine due to difference in metrics used, an excess of 30–60% of DVR is believed to be primary in origin [8–12]. Secondary DVR arises as a result of deep vein thrombosis (DVT) involving the extremity. Often the two can coexist in the same patient [13]. Primary DVR arises due to stretching/elongation of the valve cusps or dilation of the affected venous segment. A developmental etiology has also been recognized due to symptoms predating the age of actual presentation, often as early as teenage years [14]. Trauma has also been presented as a cause. Degeneration of the fibroelastic tissue of the valve that gradually develops over time is deemed the most plausible cause in a majority of patients [14]. This chapter explores the pathophysiology and management of DVR.


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Copyright information

© Springer Nature Singapore Pte Ltd. 2018

Authors and Affiliations

  • Arjun Jayaraj
    • 1
  1. 1.RANE Center for Venous and Lymphatic Diseases at St. Dominic HospitalJacksonUSA

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