Ep. 2 - Varicose Veins: Getting to the Root of Venous Issues: Iliac Vein Compression and Beyond

Dr. Craig Walker and Terry Roberts discuss varicose veins and other venous disorders on this episode of Cardiovascular Matters. They delve deeper into obstructive venous disorders like iliac vein compression syndrome, also known as May-Thurner syndrome
In this episode, Dr. Walker sits down with host Terry Roberts to explore causes of venous obstruction beyond simple varicose veins. They discuss conditions like first rib syndrome that can compress veins as well as how cancer and infections can indirectly cause obstructions. However, Dr. Walker focuses particular attention on iliac vein compression syndrome, otherwise known as May-Thurner syndrome. He explains in detail how the iliac artery can compress and reduce blood flow through the iliac vein at the spine. Left untreated, this puts patients at higher risk of dangerous blood clots and prevents healing of chronic venous ulcers.
Listeners learn the importance of considering iliac vein compression when evaluating patients with severe leg swelling, ulcers, or large clots found predominantly on one side. Dr. Walker outlines the diagnostic process which may involve ultrasound, venography, and intravascular ultrasound to visualize compression sites. He also shares how balloon angioplasty and stent placement have transformed the lives of patients who suffered for decades before receiving proper treatment.
Beyond individual patient stories, the episode offers insights into symptoms of venous obstruction and how it can impact exercise capacity and hemodialysis access. Dr. Walker contrasts treating venous strictures to arterial blockages as well. The discussion wraps by emphasizing this common problem is frequently overlooked and how advanced endovascular techniques now offer hope.
***------------- Key points discussed -------------***

• Dr. Walker discusses varicose veins and delves deeper into obstructive venous disorders like iliac vein compression syndrome (May-Thurner syndrome).
• Conditions beyond varicose veins that can cause venous obstructions include first rib syndrome, cancer, infections.
• Iliac vein compression occurs when the iliac artery crosses and compresses the iliac vein against the spine, increasing risk of clots and preventing ulcer healing.
• Diagnosis involves ultrasound initially but may require venography and intravascular ultrasound to visualize compression sites.
• Treatment is usually balloon angioplasty and stent placement to hold the vein open.
• Stories shared of life-changing impacts proper venous treatment has had for long-term patients.
• Symptoms discussed include leg swelling and shortness of breath.
• Venous disease importance for hemodialysis patients is covered.
• Venous strictures are harder to treat than arterial blockages.
• Advanced stents are now available to treat various venous obstructions

Listeners learn this common cardiovascular problem is often underdiagnosed and underestimated. Identifying and addressing venous issues can transform a patient's quality of life. This episode provides valuable information for those experiencing related symptoms.
We hope you will take the time to listen to this informative podcast. Please feel free to share it with others who may benefit from a deeper understanding of venous disorders. As always, thank you for your ongoing support of Cardiovascular Matters.