In my 30 years in vascular surgery, I have encountered many problems in the venous surgical field. At the beginning, venous trauma control was a big hurdle for a professional vascular surgeon. Then in 1970s I investigated the vein itself to determine the best storage method after vein harvesting, and to implant a newly developed inverted vein graft in an animal model. Both studies led to promising results. In the 1980s, we focused on venous aneurysms and fibromuscular dysplasia of the vein (thought to be the first reported in the world), genital varices and other unsual cases. In 1992 I helped to found the Sclerothrapy Society in Japan. Early in my third decade I studied the popliteal vein entrapment syndrome, the phenomenon caused by hypertrophied gastrocnemius muscle in spite of normal positioning of the popliteal vessels. The surgical procedure for this disease was unprecedented in the world. This idea contributed to theories about the cause of the popliteal vein thrombosis. And in this decade varicosity sclerotherapy, alone or combination with other procedures, became widely accepted throughout Japan. On the other hand, our hospital’s urologist regularly performed IVC surgery with us using techniques in IVC closure after safe removal of tumor thrombus (carcinoma) and in aortic clamping for blood pressure control without using venousvenous shunt tubes.

In my clinical overview in the venous surgery, I am especially interested in the venous compression phenomenon, the treatment of venous ulcers and the establishment of non-reconstructive venous surgery.