Phlebolymphology N°106

Pharmacological correction of total venous reflux in patients with varicose veins

Nikolai KHOREV,1 MD, PhD; Darya KUZNETSOVA,2 MD, PhD 1Department of Cardiology and Cardiovascular Surgery, Altai State Medical University, Barnaul, Russia 2Department of Pathological Anatomy, Department of Pathophysiology Altai State Medical University, Barnaul, Russia Abstract The study was aimed at evaluating the efficacy of micronized purified flavonoid fraction (MPFF) in patients with primary chronic venous disease (CVD). It included 35 patients with varicose veins of the lower extremities (18 with bilateral and 7 with unilateral lesion). A total of 53 legs with varicose veins were evaluated in 3 groups based on the CEAP (Clinical, Etiology, Anatomic, Pathophysiology classification system) clinical class:…

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Cyanoacrylate closure in the treatment of varicose veins – what is the evidence?

Nick MORRISON, MD, FACS, DBVLM Center for Vein Restoration, Phoenix, Arizona, USA Abstract Introduction Cyanoacrylate ablation for incompetent saphenous veins is a recent addition to the armamentarium of venous surgeons. It does not require the instillation of tumescent anesthesia during the procedure, thus reducing patient discomfort, and neither are compression hose necessary after treatment. Early cyanoacrylate ablation trials VenaSeal™ (Medtronic, Minnesota, USA) was the first reported use of a formulation of cyanoacrylate used in the ablation of incompetent saphenous veins. Clinical series and randomized controlled clinical trials demonstrated the safety and efficacy of this ablation method. The VeClose trial compared…

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Is compression necessary after endovenous thermal ablation of varicose veins? Clarifying a (com)pressing matter

Matthew TAN, BSc, MBBS, MRCS, AFHEA; Alun H. DAVIES, MA, DM, DSc, FRCS, FHEA, FEBVS, FLSW, FACPh Section of Vascular Surgery, Department of Surgery and Cancer, Charing Cross Hospital, Imperial College London, London, United Kingdom Abstract Chronic venous disease (CVD) represents a significant impact on patients’ lives with negative financial, social, and health-related quality of life consequences. The gold standard for treatment of varicose veins and CVD is now considered to be endovenous thermal ablation (EVTA). Although compression is widely prescribed for patients post EVTA, there is widespread disagreement on the optimal compression regimen and if compression is even required…

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The new patient-oriented tools for clinical assessment of pelvic varicose disease

Rustem VILEVICH AKHMETZIANOV, MD, PhD Doctor of Medical Sciences, Cardiovascular Surgeon of the Department of Vascular Surgery, Inter-regional Clinical Diagnostic Center of the Ministry of Health of Russia, Assistant of the Department of Cardiovascular and Endovascular Surgery, Kazan State Medical University of the Ministry of Health of Russia, Kazan, Russia Abstract This article presents a review of patient-oriented diagnostic tools currently used in patients with pelvic varicose veins (pelvic congestion syndrome, PCS), and provides rationale for using disease-specific tools, as highlighted in the international consensus documents on the diagnosis and treatment of PCS. The authors present two original diagnostic tools…

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CHIVA versus ablation

Claude FRANCESCHI, MD Angiologist, Consultant with Groupe Hospitalier Paris Saint Joseph, Paris, France Abstract CHIVA is the French acronym for Conservatrice et Hémodynamique de l’Insuffisance Veineuse en Ambulatoire, ie, Conservative and Hemodynamic Treatment of Venous Insufficiency in outpatients. Ablation is not conservative, and CHIVA is based on a different hemodynamic approach. It is counterintuitive because it is difficult to imagine that the varicose veins could disappear without ablation either by extraction or by endovenous destruction. This treatment raises scientific questions that require us to revisit our understanding of classical venous pathophysiology in light of what echo-Doppler has contributed to our…

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The place of micronized purified flavonoid fraction in the management of chronic venous disease from an international guidelines’ perspective

Sergey Gennadievich GAVRILOV, MD, PhD Jorge H. ULLOA, MD1; Sebastian CIFUENTES, MD2; Antonio SOLANO, MD2; Valentin FIGUEROA, MD2 1Vascular Surgeon, Chief of Vascular Surgery Department, Fundación Santa Fe de Bogotá University Hospital; Professor of Surgery, Universidad de los Andes School of Medicine, Bogotá, Colombia. 2Vascular Surgery Research Fellow, Vascular Surgery Department, Fundación Santa Fe de Bogotá University Hospital, Bogotá, Colombia. Abstract Chronic venous disease (CVD) is a highly prevalent disorder with a broad spectrum of symptoms determined by disease stage and whether there is deep or superficial venous system compromise. The treatment goal for CVD is to slow and prevent…

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Phlebolymphology N°106 – Editorial

Dear Readers, In this new issue of Phlebolymphology you will find the articles as below: J. ULLOA, S. CIFUENTES, A. SOLANO, and V. FIGUEROA (Colombia) review several cardiovascular disease (CVD) management guidelines published by prestigious academic associations around the globe and summarize their recommendations about the use of micronized purified flavonoid fraction (MPFF) and the corresponding level of evidence, providing clinicians with a straightforward and practical source document to include MPFF in daily practice. C. FRANCESCHI (France) introduces the basis of the CHIVA technique (Conservative and Hemodynamic Treatment of Venous Insufficiency), including the pathophysiological perspective, and makes a comparison with…

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Phlebolymphology N°106 (Vol 29 – N°1 – 2022)

Editorial PHLEBOLOGY The place of micronized purified flavonoid fraction in the management of chronic venous disease from an international guidelines’ perspective Jorge H. ULLOA, Sebastian CIFUENTES, Antonio SOLANO, Valentin FIGUEROA (Colombia) Phlebolymphology – 2022 ; 29 (1): 3 CHIVA versus ablation Claude FRANCESCHI (France) Phlebolymphology – 2022 ; 29 (1): 9 The new patient-oriented tools for clinical assessment of pelvic varicose disease Rustem Vilevich AKHMETZIANOV (Russia) Phlebolymphology – 2022 ; 29 (1): 16 Is compression necessary after endovenous thermal ablation of varicose veins? Clarifying a (com)pressing matter Matthew TAN, Alun H. DAVIES (United Kingdom) Phlebolymphology – 2022 ; 29 (1):…

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