1. CASE PRESENTATION ADVANCED PHLEBOLOGY AND DEEP VEIN COURSE American College of Phlebology - November 15, 2012 Stephen F. Daugherty, MD, FACS, RVT, RPhS Clarksville, Tennessee

2. 57 y/o woman presents for evaluation of progressing leg pain, edema, and varicose veins, LLE>>>RLE 1979 initial symptoms with dx left calf DVT 1980 left calf SVT Warfarin and light compression stockings since 1979 No pelvic or abdominal symptoms Frequent syncopal episodes for years

5. INITIAL MANAGEMENT PERIODIC LEG ELEVATION CALF MUSLCE PUMP EXERCISES WEIGHT LOSS ADVICE GRADUATED ELASTIC COMPRESSION 30-40 mm Hg THIGH LENGTH HOSE