ABSTRACT
The treatment of chronic outflow obstructions has previously been largely neglected
because of diagnostic difficulties and lack of appropriate surgical interventions. The open
venous bypass surgery has been unattractive for several reasons and restricted to a
minority of patients with severe disabling symptoms. Endovascular treatment of venous
outflow obstruction with percutaneous stenting has drastically changed the treatment
and view on venous outflow obstruction. The introduction of venous stenting has
refocused the interest on the role of venous outflow obstruction in patients with chronic
venous disorders, and has renewed interest in the nature and pathophysiology of venous
obstruction in itself and in tests for detection of hemodynamically significant lesions. Iliac
venous stenting has already largely replaced surgery as the “method of choice” for
treatment of venous blockage. However, venous stenting is still under development, and
there are several issues regarding diagnosis, methods of assessment and selection of
patients, which needs to be resolved.
