Phlebolymphology N°66

V – Treatment

Acute venous disease Deep venous thrombosis – how to treat in daily practice? A. Comerota In the first part of his presentation, A. Comerota dealt with the high prevalence of postthrombotic syndrome (PTS) in patients with iliofemoral DVT and defended the American College of Chest Physicians (ACCP) guidelines recommending thrombus removal, including venous thrombectomy and catheter-based procedures designed to eliminate clots, in patients with iliofemoral DVT. Following venous thrombectomy, patients should receive the same intensity and duration of anticoagulation as those patients who are treated with anticoagulation alone (ACCP recommendation Grade 1 C). In the author’s opinion, catheter-directed thrombolysis is…

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IV – Investigations

Acute venous disease Guest lecture Chairperson: M. de Maeseneer Asymptomatic deep vein thrombosis W. Blättler The term “asymptomatic” could in fact have several meanings – the symptoms (pain or edema) can be truly absent, unrecognized, misinterpreted or masked by another problem. The intensity and character of signs and symptoms depend on how fast the thrombotic process develops and on the location and extent of DVT. The sensitivity of DVT signs and symptoms is much lower in bed-ridden patients than in outpatients. During clinical probability assessment, not only signs and symptoms but also risk factors of DVT should be taken into…

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III – Pathophysiology

Guest lecture Chairperson: M. Malouf Why do varicose veins develop? N. Labropoulos N. Labropoulos gave an overview of current knowledge and theories on the pathophysiology of varicose veins. He reminded the audience of the high prevalence of this disease, particularly in developed countries, and its specificity to humans, which renders investigations on animal models impossible. The talk focused on primary venous disease, hence excluding postthrombotic syndrome, in which obstruction and valve destruction occurs. Venous hypertension plays a major role in the progression of the disease. It provokes vein dilatation and inflammation. Vein dilatation leads to distortion, leakage, and altered shear…

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II – Epidemiology

Varicose Veins Chairperson: M. Perrin Moderator: J. Barrett Epidemiology of varicose veins E. Rabe E. Rabe commented on the epidemiological results of Bonn Vein Study part I and remarked on the absence of epidemiological studies with long follow-up. This was one of the reasons for designing the second part of this study. The Bonn Vein Study part II includes the same population and procedures as in the previous phase, with a follow-up of 6.6 years. The objectives of this study were to analyze the incidence of venous disorders in the general population, progression of chronic venous disease and risk factors…

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I – UIP consensus, UIP fellowships

Introduction to the UIP Consensus Project By E. Rabe Scientific and educational progress in phlebology in recent years has led to a higher demand for communication between phlebologists worldwide. At the same time specialization in phlebology by medical associations and the setting up of master degree programs in phlebology are increasing. For these reasons the Executive Committee of the UIP decided to establish a common platform to promote phlebology worldwide. The first steps in this direction were taken by means of the consensus papers of the UIP on anatomy, definition of terms in the CEAP classification, evidencebased compression treatment and…

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Preface

The 16th World Meeting of the Union Internationale de Phlébologie which celebrated the 50th anniversary of the Union founded in Meyrargues, near Monaco, closed a year of many new activities started in the UIP. One major activity was the inauguration of consensus groups, working towards a worldwide curriculum of phlebology. The reinforcement of the UIP Fellowships with a new supportive sponsor is in line with the aim of the UIP to encourage studies and research on disorders of venous origin. In addition, the UIP started a big epidemiological project in cooperation with Servier, the Vein Consult Program, which will enable…

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Phlebolymphology N°66 (Vol 17 – N°1)

Special congress issueXVIth World Meeting of the Union Internationale de Phlébologie (UIP) Principality of Monaco August 31-September 4, 2009 Preface 1. UIP consensus, UIP fellowships 2. Epidemiology 3. Pathophysiology 4. Investigations 5. Treatments

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