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Previous Volume 360:2319-2327 May 28, 2009 Number 22 Next

	Since this article has no abstract, we have provided an extract of the first 100 words of the full text and any section headings.

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This Journal feature begins with a case vignette highlighting a common clinical problem. Evidence supporting various strategies is then presented, followed by a review of formal guidelines, when they exist. The article ends with the authors' clinical recommendations.

A 52-year-old receptionist presents with an ulcer on her ankle that has persisted for a year. The use of narcotic analgesics once or twice a day and elevation of the leg reduce the pain. She does not have a history of diabetes and does not smoke. Physical examination reveals an ulcer, approximately 5 cm in diameter, above the medial malleolus. The ulcer . . . [Full Text of this Article]

The Clinical Problem

Strategies and Evidence

Evaluation

Classification

Imaging

Treatment Options

Compression Stockings

Drug Therapy

Corrective Procedures

            Ablation of Angiomas and Varicosities

            Ablation of the Saphenous Veins

            Interruption of the Perforator Veins

            Treatment of Iliac-Vein Obstruction

            Deep-Valve Reconstruction

Areas of Uncertainty

Guidelines

Conclusions and Recommendations

Source Information

From the University of Mississippi Medical Center (S.R.) and River Oaks Hospital (S.R., P.N.), Jackson.

An audio version of this article is available at NEJM.org.

Address reprint requests to Dr. Raju at 1020 River Oaks Dr., No. 420, Flowood, MS 39232, or at rajumd@earthlink.net.

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