Treatment of venous disease does not have the "cachet" of a complex endovascular aneurysm repair, an inframal-leolar bypass, or even a routine carotid endarterectomy in vascular surgical circles; but all who care for patients with vascular diseases understand well the staggering volume of these problems and morbidity of poorly treated events. Venous problems outnumber aortic, extremity arterial, and carotid problems combined; it is estimated that one-half of one percent of all people in the western world, for example, will have a venous ulcer at some point in their lives. The treatment of venous disease is much like getting into a cold swimming pool; if you do it half-heartedly or bit by bit, it can be very painful, but if you immerse yourself fully and get serious about it, you will succeed.