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Sustained venous hypertension is associated with histologic and ultrastructural changes that lead to increased vascular permeability (edema) and the chronic release of inflammatory mediators that are the fundamental cause of cutaneous hyperpigmentation, trophic skin changes and ulceration.12 New techniques using radiofrequency ablation by vein specialists for patients with venous reflux disease have been promising for those formerly relegated to compression with weekly Unnas boot changings and Jobst stockings
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