Clinical Applications of Venous Treatment
Recent data from the literature suggest a greater role of chronic venous insufficiency in the pathogenesis of a
variety of brain disorders. The goal of this talk is to review the contributions made in 2014 to our enhanced
understanding of the safety and efficacy of the endovascular or open surgical treatment of chronic venous
obstruction in patients with a variety of pathologies including multiple sclerosis, transient global amnesia,
Alzheimer’s disease, Parkinson’s disease, postural orthostatic tachycardia syndrome, transient monocular
blindness, headaches, and spontaneous intracranial hypertension. Open surgical interventions including, but
not limited to operative venous bypass, transposition, venoplasty, and vein interposition have been reported.
Endovascular procedures detailed in the medical literature include balloon angioplasty, cutting or scoring
balloon angioplasty, self-expanding and balloon expandable stent placement, and stent-grafting. In general, all
these therapies have been used to treat stenosis and/or occlusions of the jugular and/or azygous veins
associated with increased collateral venous drainage. The relationship between anatomic findings and any
symptoms related to the range of neurological disorders listed above has not been established and further
research is required.
MICHAEL D. DAKE, M.D.
Thelma and Henry Doelger Professor (III)
Department of Cardiothoracic Surgery
Stanford University School of Medicine
I am grateful for Dr. Dake's continued involvement. Were any of those open surgical interventions not previously discussed here? Operative venous bypass, transposition, venoplasty, and vein interposition?