Phlebolymphology N°63

Shave therapy for venous ulcers – a review and current results

Hans Joachim HERMANNS Peter WALDHAUSEN Clinic for Vascular Medicine, Venous and Wound Care Center, Krefeld, Germany SUMMARY Shave therapy was established by Schmeller, mostly in Europe, and is not common in the international literature. The technique involves layered tangential and only suprafascial necrosectomy and fibrosectomy of nonhealing venous leg ulcers, combined with simultaneous skin grafting. In spite of very good long-term results confirmed by several investigators and published as a retrospective analysis, there are no prospective and randomized studies. Long-term healing rates between 70% and 80% for recalcitrant venous leg ulcers are very good, and no other current method is…

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About new articles and books

Based on an original review: Kakkos SK, Caprini JA, Geroulakos G, Nicolaides AN, Stansby GP, Reddy DJ. Combined intermittent pneumatic leg compression and pharmacological prophylaxis for prevention of venous thromboembolism in high-risk patients. Cochrane Database Syst Rev. 2008, Issue 4. Art. No.: CD005258. DOI:10.1002/14651858.CD005258. pub2 Stavros K. KAKKOS1 Joseph A. CAPRINI2 George GEROULAKOS3 Andrew N. NICOLAIDES4 Gerard P. STANSBY5 Daniel J. REDDY1 1 Division of Vascular Surgery, Department of Surgery, Detroit, USA 2 Department of Surgery, Evanston Northwestern Healthcare, Evanston, USA 3 Vascular Unit and Department of Vascular Surgery, Ealing Hospital and Imperial College, London, Southall, UK 4 Vascular Screening…

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Amniotic membrane: An innovative treatment of refractory vascular ulcers?

Francis PESTEIL* Mireille DROUET** Marie-Claire ROUSANNE*** Philippe LACROIX* * Service de Chirurgie Thoracique, Cardio- Vasculaire et Angiologie, CHU Dupuytren, Limoges, France ** Service d’Immunologie, CHU Dupuytren, Limoges, France *** Etablissement français du sang Aquitaine- Limousin ABSTRACT Mixed arterial and venous ulcers often heal poorly if there is no revascularization, as observed in the elderly, diabetics, and chronic renal failure patients who often have diffuse, distal, and calcified vascular lesions. Treatment therefore is based on optimized local wound care, pain control, and management of the risk of infection inherent in these types of patients with chronic wounds. Current avenues of research…

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Nutcracker syndrome

Olivier HARTUNG Service de Chirurgie Vasculaire, Centre Hospitalier Universitaire Nord, Marseille, France The nutcracker syndrome is quite a rare condition. It is due to the compression of the distal segment of the left renal vein (LRV) between the superior mesenteric artery (SMA) and the aorta (also called left renal vein entrapment). El Sadr reported the first case in 1950,1 but De Schepper named it.2 This syndrome needs treatment when symptoms are disabling. ANATOMY The LRV arises from the left kidney and opens into the inferior vena cava after 5 to 9 cm (Figure 1). In its distal part, the LRV…

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Radiofrequency ablation of the incompetent saphenous vein-lessons learned

Robert F. MERCHANT The Reno Vein Clinic, Reno, Nevada INTRODUCTION Investigations into the therapeutic use of radiofrequency (RF) energy in man occurred as early as the late 19th and early 20th centuries. Technological advances increased interest in RF applications. Because of its precise control of energy delivery and reliability, RF energy has been used for decades in neurosurgical techniques.1 By the 1980s cardiac arrhythmias were being treated with RF devices.2 Usage expanded to include treatment of various malignancies (including hepatic, renal, musculoskeletal, breast, lymph, spleen, pulmonary),3,4 as well as ophthalmologic maladies, gastric reflux, sleep apnea, and aesthetic dermatological conditions.5,6 Berjano…

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Phlebolymphology N°63 (Vol 16 – N°2 – 2009)

EDITORIAL Editorial H. Partsch – Phlebolymphology – 2009 ; 16(2): 236 PHLEBOLOGY Radiofrequency ablation of the incompetent saphenous vein—lessons learned R. F. Merchant – Phlebolymphology – 2009; 16 (2): 237 Nutcracker syndrome O. Hartung – Phlebolymphology – 2009; 16 (2): 246 Shave therapy for venous ulcers —a review and current results H. J. Hermanns, P. Waldhausen – Phlebolymphology – 2009; 16 (2): 253 Amniotic membrane: an innovative treatment of refractory vascular ulcers? F. Pesteil, M. Drouet, M.-C. Rousanne, P. Lacroix – Phlebolymphology – 2009; 16 (2): 259 ABOUT NEW ARTICLES   A review by Stavros K. Kakkos A review by…

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Phlebolymphology N°63 – Editorial

Dear Readers, Fascinating topics are presented in this issue of Phlebolymphology. Robert F. Merchant, USA, who is one of the pioneers of catheter-based radiofrequency ablation as a less invasive alternative to conventional vein stripping, gives very useful recommendations for improving the results of this method by using modifications of the original technique and innovations in equipment. The material presented is based on an outstanding review of clinical trials comparing different methodologies. The nutcracker syndrome is a clinical entity not well known to most phlebologists. Olivier Hartung from Marseille gives a comprehensive overview of this compression syndrome, in which the left…

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