Phlebolymphology N°55

MPFF at a dose of 500 mg and chronic venous insufficiency

Françoise PITSCH Servier International Paris, France WHAT IS CHRONIC VENOUS INSUFFICIENCY? The term chronic venous insufficiency (CVI) is defined by Ruckley1 as “the signs of that category of venous disease in which there are chronic pathologic changes in the skin and subcutaneous tissues of the lower leg. Subjects with truncal varices are not classified as CVI unless they have corona phlebectatica, lipodermatosclerosis, or open ulceration.” The term “insufficiency” deserves a clear-cut definition. It usually refers to the failure of an organ or of a given function. So, valvular insufficiency can be denoted as venous valve failure, and venous insufficiency as…

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Recent findings in the pathogenesis of venous wall degradation

Michel René BOISSEAU1,2 Département de Pharmacologie Université Victor Segalen Bordeaux 2 Bordeaux, France SUMMARY Increased venous pressure in the erect position is a constant finding in patients with chronic venous disease. In the case of primary chronic venous disease, this increase in venous pressure is linked to venous reflux. A linear relationship exists between increased ambulatory venous pressure and skin ulceration. The length of time a subject is exposed to elevated venous pressure is a major factor in the progression of venous disease and in the development of varicose veins. The development of an animal model of venous hypertension (VHT)…

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Book review

MECHANISMS OF DISEASE: CHRONIC VENOUS DISEASE A commentary by Michèle Cazaubon NEW ENGLAND JOURNAL OF MEDICINE Mechanisms of Disease: Chronic Venous Disease J. Bergan, G.W. Schmid-Schonbein, P. Coleridge-Smith, A.N. Nicolaïdes, M.R. Boisseau, and B. Eklof N Engl J Med. 2006;355:488-498. (2006 Massachusetts Medical Society ISSN-0028-4793 Web site: www.nejm.org) We are pleased to see publication of an article on venous disease in one of the most prestigious reference medical journals. It is an article designed to improve our understanding of the mechanisms that lead to chronic venous disease, and its excellent quality is to be expected considering the authors. Problem position:…

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Artificial venous valves: an ongoing quest to treat end-stage deep venous insufficiency

Michael C. DALSING Indiana University School of Medicine Indianapolis, USA ABSTRACT End-stage deep venous insufficiency is unrelenting venous hypertension with sequelae, and no standard option is available, or all options have been tried and found wanting. In such cases, there is an opportunity for an artificial venous valve to be used as a native valve. For decades, substitute valves have been studied experimentally, raising hope of bench-to-bedside transfer. This quest is reviewed with an emphasis on current clinical practice. Venous valves have been made entirely of non-autologous tissues: synthetics, xenografts, or allografts. Many have failed in early experimental evaluation, with…

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Subjective venous symptoms: review and presentation of a pilot study

Michael KENDLER1 Eva HAAS2 1. University of Leipzig Dep. Dermatology Leipzig, Germany 2. Laufen, Germany SUMMARY In phlebology practice, the symptoms of heavy legs, feeling of swelling, fatigue, and the sensation of tension in the leg (heavy leg syndrome) are often found without an organic cause. These patients frequently suffer from psychic disturbances accompanied by a reduced quality of life. The discrepancy between symptoms and lack of objective findings leads to an ineffective therapy. In this article we discuss the problem of leg symptoms without varicose veins and present a survey of heavy leg syndrome and quality of life in…

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Endovenous laser ablation

Jean-François UHL1,2 Steven E. ZIMMET2,3 Zimmet Vein and Dermatology Clinic Austin, USA ABSTRACT Endovenous laser ablation (EVLA) is a less invasive alternative to vein stripping. Outcomes seem equal to, or better than, those with stripping, with better quality of life scores in the post-operative period. EVLA has been shown to correct or significantly improve hemodynamic abnormality in patients with chronic venous insufficiency (CVI) with superficial venous reflux. Early reports suggest that endovenous ablation techniques, in contrast to surgical stripping, are associated with a low incidence of neovascularization. A variety of wavelengths are being used to perform EVLA. While the initial…

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Phlebolymphology N°55 – Editorial

Laser ablation of the great saphenous vein is a technique whose use has expanded dramatically during the last few years. Endovenous techniques without groin incision and high ligation are certainly less invasive than conventional vein stripping, and seem to involve less risk of neovascularization. Steven Zimmet from Austin, Texas, the immediate Past President of the American College of Phlebology, gives a well-balanced overview of laser ablation, including the mechanisms of action, technical details, results, adverse sequelae, and complications. Using tumescent anesthesia, this procedure can be performed in-office without general anesthesia or surgical incisions. Michel R. Boisseau, Pharmacology Department of the…

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Phlebolymphology N°55 (Vol 14 – N°2 – 2007)

EDITORIAL Editorial H. Partsch – Phlebolymphology – 2007 ; 14(2): 50 PHLEBOLOGY Endovenous laser ablation S. E. Zimmet – Phlebolymphology – 2007; 14 (2): 51 Recent findings in the pathogenesis of venous wall degradation M. R. Boisseau – Phlebolymphology – 2007; 14 (2): 59 MPFF at a dose of 500 mg and chronic venous insufficiency F. Pitsch – Phlebolymphology – 2007; 14 (2): 69 Subjective venous symptoms: review and presentation of a pilot study M. Kendler – Phlebolymphology – 2007; 14 (2): 74 Artificial venous valves: an ongoing quest to treat end-stage deep venous insufficiency M. C. Dalsing – Phlebolymphology…

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