Have you or a loved one struggled with painful, persistent venous ulcers? In this episode of Cardiovascular Matters, Dr. Craig Walker sheds light on venous disease - a common condition that often goes undiagnosed and untreated.

Dr. Walker's interest in venous issues began early in his career while working to open blocked arteries and access the heart. It was in wound healing centers that he noticed the majority of patients suffered from debilitating venous ulcers, not arterial issues. These ulcers could last decades, constantly weeping and requiring bandage changes day and night.

One key culprit is iliac vein compression - where the large veins in the abdomen become squeezed between the aorta and spine. Dr. Walker explains the anatomy and risk factors for compression, detailing how it raises venous pressures and predisposes people to ulcer formation. But for years, there were no effective treatments.

That changed with pioneering work by Dr. Raju using minimally invasive vein stenting. Dr. Walker was amazed by the rapid ulcer healing he saw in patients. Now newer stents and techniques have made the procedure even safer.

In this episode, Dr. Walker shares real case studies of patients with 20+ year ulcers that fully healed within months of stenting. He stresses the importance of evaluating for compression in anyone with longstanding ulcers or discolored legs. Tune in to learn more about diagnosis and new hope for patients suffering from this debilitating condition.

Here are the key points discussed in the podcast episode:

• Dr. Walker's career path led him to recognize the prevalence of venous disease issues over arterial problems when working in wound healing centers.
• Venous ulcers are one of the most common problems treated, often lasting decades and severely impacting quality of life.
• Iliac vein compression, where the iliac veins in the abdomen become squeezed, is a major underlying cause of venous hypertension and ulcer formation.
• Risk factors for compression include family history, obesity, recurrent leg clots, and discolored skin below the knees.
• Non-invasive testing like ultrasound has limitations - intravascular ultrasound placed in the vein is the gold standard diagnostic test.
• Pioneering work by Dr. Raju in the 1990s demonstrated minimally invasive vein stenting could effectively decompress veins and rapidly heal ulcers.
• Newer stents, balloons and techniques have made the outpatient stenting procedure even safer and more successful.
• Case studies showed ulcers persisting over 20 years could fully heal within 6-8 weeks post-stenting.
• Anyone with longstanding ulcers or symptoms should be evaluated for possible iliac vein compression.