Phlebolymphology N°84

2.6 Other

Behcet disease: an atypical DVT. Diagnosis and treatment. M. Bouayed Behcet’s disease (BD) is a primitive multisystematic vasculitis nonautoimmune disease of unknown etiology. It is exceptional after the age of 60 and common in the Mediterranean basin and in Japan. The International Clinical Criteria from 1990 are recurrent oral ulcers, recurrent ulcers more than three times in 12 months, and two of the following: recurrent genital ulcerations, eye-injury, skin-lesions, and a positive pathergy test (sensitivity, 91% and specificity, 96%). The vascular lesions are highly suggestive of an attack on the arteries and veins of any caliber. In the vascular lesions,…

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3. Venous leg ulcer

Retrospective study assessing the efficacy of electrical stimulation on leg ulcer pain. P. Leloup, P. Toussaint, J. P. Lembelembe et al The authors presented the results of the first study on the efficacy of electrostimulation in leg ulcer pain, demonstrating that this method may improve pain control as assessed by the evolution of a subjective criterion (visual numeric scale) and a target (reduced consumption of analgesics). Several clinical studies have demonstrated the efficacy of electrostimulation in chronic wound healing by applying an electric current directly to the ulcer. Electrostimulation increases angiogenesis as well as migration and proliferation of macrophages, fibroblasts,…

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2. Venous malformation

Characteristics and monitoring of venous malformations in children. C. Boulard, Y. Surlemont, E. Clavier et al The study is focused on the characteristics and the way of monitoring venous malformations in children. These malformations are general vascular congenital anomalies with a slow flow developing in parallel with the child’s growth. The study presents the results of an observational retrospective analysis developed at the CHU-Hospital of Rouen, in consultations covering several medical areas over the year 2000. There were 23 girls and 22 boys with venous malformations included, with the average age of 7 (3 months to 18 years old), who…

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1. Hemangiomas

Propranolol in the treatment of infantile hemangiomas: Results from an international randomized, placebo-controlled, multidose, adaptive phase 2/3 study. C. Leaute-Labreze, J. Mazereeuw-Hautier, L. Guibaud et al. The study was conducted at the suggestion of the European Medical Association (EMA) and the Food and Drug Administration (FDA) and was an international, multicenter, randomized, double-blind, adaptive phase 2/3 study. The authors presented the results of this study, which was conducted at 56 centers in 24 countries on 460 children aged 1 to 5 months, who were treated for infantile proliferative hemangioma with a pediatric formulation of oral propranolol for 24 weeks. The…

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6. EVF prizes

American Venous Forum Ovarian vein thrombosis (OVT) rarely occurs, so data on clinical presentation, natural history, and treatment outcomes are lacking. RD. Malgor and colleagues (USA) presented their own data in the lecture titled “The natural history and treatment outcomes of symptomatic ovarian vein thrombosis.” They examined 23 patients with symptomatic OVT (mean age, 44). The most frequent causes of OVT were postpartum depression and cancer, and the most frequent symptoms were abdominal and flank pain. Location was mostly on the right. Intravenous heparin leads to complete recanalization in 62% of patients and incomplete recanalization in 15% of patients, while…

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5. Thromboembolic diseases

Venous thromboembolism Factors affecting long-term outcome in patients with iliofemoral DVT treated with catheter directed thrombolysis. P. Foegh, L. P. Jensen, L. Klitfod, S. Just, R. Broholm, N. Baekgaard The Danish team investigated factors affecting long-term outcomes in patients with iliofemoral deep venous thrombosis (DVT) treated with catheter-directed thrombolysis. This method is not widely used because of its cost, but also because its effectiveness is questionable. The team achieved very good results on 203 limbs with iliofemoral DVT. Median follow-up was 5 years and the rate of reocclusion was only 13%. The factors in favor of good outcomes were female…

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4. Treatment of iliac and caval veins

Morphologic changes in iliac veins and inferior vena cava in patients with primary varicose veins. L. Dzieciuchowicz During high ligation and stripping in 20 patients with primary varicose veins, the author used intravascular ultrasound to detect nonthrombotic stenosis of iliac veins and the inferior vena cava. No intraluminal lesions were detected, but stenosis of the iliac veins seemed to be common in patients with primary varicose veins.

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3. Treatment of perforating veins

Which perforating veins should be treated? J-J. Guex The role of perforating veins in the pathogenesis of chronic venous disease (CVD) is controversial. Now the question being debated is: should we treat perforators and if so, which perforator(s)? The usual attitude is to not treat medial leg perforating veins, irrespective of whether they are incompetent or not. That is why their incompetence in primary disease is a consequence of great saphenous vein (GSV) reflux, which is shown by their disappearance after GSV ablation. No data was published on the efficacy of dissecting perforators in terms of clinical results or recurrences….

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2. Treatment of saphenous veins

Management of saphenous reflux in 2014 Comparative efficacy of different methods of treatment. M. de Maeseneer This was an excellent summary on the current situation with comparative efficacy of different methods of saphenous reflux treatment. While endovenous thermal ablation is recommended by several international guidelines as a first-choice treatment, no strong data exist supporting that those methods can get better results than surgery. Modern phlebectomy is as effective in terms of recurrence and quality of life as thermoablation. In our daily practice: which technique for which patient? C. Hamel-Desnos Ultrasound-guided foam sclerotherapy might be the most used technique in France….

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