Phlebolymphology N°105

Microcirculatory disorders in chronic venous diseases and fundamentals of their systemic pharmacological correction

Olga Ya POREMBSKAYA, MD, PhD Mechnikov North-Western State Medical University, Saint Petersburg, Russia and Institute of Experimental Medicine, Saint Petersburg, Russia Abstract This article reviews the literature on microcirculatory disorders underlying the development of chronic venous diseases (CVD) across all the CEAP (Clinical-Etiology- Anatomy-Pathophysiology) clinical classes from C0s to C6 and the fundamentals of their systemic pharmacological correction particularly with micronized purified flavonoid fraction (MPFF). Anatomical and functional changes specifically in the vessels of the microvasculature are the main pathogenetic mechanism for the development of most vein-specific symptoms and determine CVD progression. The altered vessels of the microvasculature are characterized…

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Management of venous ulceration (interventional treatments) with perspectives from a recent meta-analysis and recommendations

Nicolas NEAUME, MD Clinique Pasteur, Toulouse, France Abstract Venous leg ulcers still affect about 1% of the adult population despite recent advances in chronic venous insufficiency treatment, and they represent a significant public health cost, estimated at between 1% and 2% of the annual health budget of Western European countries. Venous leg ulcers may be treated conservatively, with compression bandaging and wound care, medically, surgically, or with a combination of approaches, depending on the severity of the ulcer and available resources. The randomized trial of early endovenous ablation in venous ulceration demonstrated that early removal of a superficial venous reflux…

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Dialogue on venous hemodynamics

Oscar MALETI,1 MD: Fedor LURIE,2 MD, PhD; Giorgio BERGAMO,3 BSc; Sara GUERZONI,4 BSc; Marzia LUGLI,1 MD 1Vascular Surgery, Hesperia Hospital, Modena, Italy 2Jobst Vascular Institute and the Division of Vascular Surgery at the University of Michigan, Ann Arbor, Michigan, USA 3Microlab Elettronica Sas. Padova, Italy 4Fleboxan Vein Clinic, Modena, Italy Abstract Hemodynamics of the venous system of the lower limbs is very complex, its explanation typically evoking formulas and concepts that can be daunting for those new to the subject. Here, we approach the task from a more conversational angle, introducing a dialogue between expert and student as they discuss…

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Anticoagulation and interventional treatment of varicose veins

Matthieu JOSNIN, MD Saint Charles Clinic, Interventional Phlebology Unit, La Roche-sur-Yon, France Abstract Venous thromboembolic risk is very low after varicose vein procedures. This risk is often cited as less than 1%; however, studies also show the risk to be highly variable. Overall, literature in the field does not typically conclude thromboprophylaxis to be necessary in low-risk patients, owing to the low incidence of the event studied and the often-insufficient number of patients included. Despite the low incidence, venous thromboembolic risk is important in terms of mortality and morbidity. Varicose veins affect an average of 1 in 3 individuals, and…

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Combination of May-Thurner syndrome and pelvic congestion syndrome: terra incognita

Sergey Gennadievich GAVRILOV, MD, PhD Professor of Surgery, Savelyev University Surgical Clinic, Pirogov Russian National Research Medical University, Russia Abstract This review presents up-to-date data on the pathophysiology, epidemiology, classification, diagnosis, and treatment of the combination of May-Thurner syndrome (MTS) and pelvic congestion syndrome (PCS). It includes hypotheses to explain the predominant lesion of the pelvic veins in these patients and describes in detail the clinical symptoms of combined lesions of the iliac and pelvic veins. The article discusses modern methods of diagnosis of MTS and PCS, as well as advantages and disadvantages of ultrasound and radiological methods of investigation….

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Phlebolymphology N°105 – Editorial

Chronic venous disease management: Thematic index of randomized controlled trials Michel PERRIN, MD Vascular Surgery; Editor in Chief of Phlebolymphology There is currently no available index on chronic venous disease (CVD) management allowing the quick and easy identification of pertinent randomized controlled trials. Furthermore, it can be difficult to determine from article titles what precise treatment–whether interventional or not–and diagnosis tool were used in the studies, which can be problematic. To address this issue, we developed an index of treatment procedures and diagnosis methods as explained below (and in a simplified version in Table I). There are currently 11 chronic…

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Phlebolymphology N°105 (Vol 28 – N°3 – 2021)

Editorial PHLEBOLOGY Combination of May-Thurner syndrome and pelvic congestion syndrome: terra incognita Sergey Gennadievich GAVRILOV, (Russia) Phlebolymphology – 2021 ; 28 (3): 90 Anticoagulation and interventional treatment of varicose veins Matthieu JOSNIN, (France) Phlebolymphology – 2021 ; 28 (3): 103 Dialogue on venous hemodynamics Oscar MALETI, (Italy) Phlebolymphology – 2021 ; 28 (3): 111 Management of venous ulceration (interventional treatments) with perspectives from a recent meta-analysis and recommendations Nicolas NEAUME, (France) Phlebolymphology – 2021 ; 28 (3): 119 Microcirculatory disorders in chronic venous diseases and fundamentals of their systemic pharmacological correction Olga Ya POREMBSKAYA, (Russia) Phlebolymphology – 2021 ; 28…

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