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Comparing the arterial and venous collateral circulation interesting symmetries are detected as well as important differences. Venous compensating pathways are essentially intra-parenchymal and convey dirty as deoxygenated blood. The hypothesis of the toxic effects of the venous collateral circulation is formulated, i.e. the greater the volume of compensation, the greater the toxic damage. Two scenarios are previewed as possible targets, i.e. the postthrombotic syndrome (PTS) and the chronic cerebrovascular insufficiency (CCSVI).