THE PATHOGENESIS OF PHLEBOSCLEROSIS: ITS RELATION TO ARTERIOSCLEROSIS. III. PHLEBOSCLEROSIS OF THE INFERIOR VENA CAVA

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Abstract
Phlebosclerosis of the inferior vena cava is usually the result of congestive failure. Evidence is submitted that the prolongation of the elevated intravenous pressure is more important in the genesis of the lesion than is the degree of elevation. Atheroma in phlebosclerosis was entirely absent. In every instance vena caval phlebosclerosis was accompanied by sclerosis of the pulmonary artery. However, the reverse is not always true. Sclerosis of the portal vein is associated in about a third of the total cases with sclerosis of the inferior vena cava, and evidence is submitted that its incidence is more dependent upon the prolongation of the intracaval pressure than upon the degree of its elevation. Evidence is also submitted that the development of sclerosis in the vena cava may be measured in terms of months rather than of years. The Cramer-Schilling lesion in the inferior vena cava is described and its significance indicated. Finally, the significance of the pathogenesis of phlebosclerosis to the problem of the pathogenesis of arteriosclerosis and atherosclerosis is discussed.