Phlebolymphology N°89

What is postthrombotic venous obstruction and how can it be avoided?

What is postthrombotic venous obstruction and how can it be avoided? Anthony J. COMEROTA, MD, FACS, FACC Director, Jobst Vascular Institute, The Toledo Hospital, Toledo, OH, USA; Adjunct Professor of Surgery, University of Michigan Abstract Postthrombotic venous obstruction is part of the pathophysiology of a postthrombotic syndrome. When the obstruction occurs in the iliofemoral segment, postthrombotic morbidity is often severe. In a recent study, the intraluminal contents of chronically occluded postthrombotic common femoral veins were analyzed. Approximately 80% to 90% of the tissues analyzed were composed of type I collagen, with type III collagen comprising the remainder. Vascular endothelial growth…

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Role of duplex ultrasound investigation in the management of postthrombotic syndrome

Role of duplex ultrasound investigation in the management of postthrombotic syndrome Olivier PICHOT, MD Caroline MENEZ, MD Service de Médecine Vasculaire, CHU de Grenoble, France Abstract Duplex ultrasound is a method for analyzing the anatomy and hemodynamic profile of lower-limb veins; it can also be used for pelvic and abdominal examinations. For postthrombotic syndrome, duplex ultrasound can recognize specific anatomical abnormalities in the venous lumen, wall, and valves. Reflux can be easily diagnosed with duplex ultrasound, although some controversy is present concerning the extent of the reflux detected compared with descending venography. Venous obstruction is more challenging to quantify; nevertheless,…

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Phlebolymphology N°89 – Editorial

Dear Readers, At the end of 2015, Servier asked me to become the editor-in-chief of Phlebolymphology. I accepted without hesitation as in the last two decades Phlebolymphology has become an excellent journal, particularly in terms of research updates and the treatment of venous and lymphatic disease. The Phlebolymphology website also lists: All randomized control trials regarding treatment of varicose veins, classified either by author or topic, plus their abstracts. The references of all articles published since 1990 on the presence of varices after operative treatment (PREVAIT), under 8 headings. Randomized control trials on operative management of varicose veins and information…

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Phlebolymphology N°89 (Vol 23 – N°2 – 2016)

EDITORIAL Editorial By Michel PERRIN (Chassieu, France) Phlebolymphology – 2016 ; 23 (2): 58 PHLEBOLOGY An update on operative treatments of primary superficial vein incompetence: part 2 Michel PERRIN (Chassieu, France) Phlebolymphology – 2016 ; 23 (2): 59 What is postthrombotic venous obstruction and how can it be avoided? Anthony J. COMEROTA (Toledo, USA) Phlebolymphology – 2016 ; 23 (2): 76 Chronic venous disorders: pharmacological and clinical aspects of micronized purified flavonoid fraction Arnaud MAGGIOLI (Suresnes, France) Phlebolymphology – 2016 ; 23 (2): 82 Testing the potential risk of developing chronic venous disease: Phleboscore Philippe BLANCHEMAISON (Paris, France) Phlebolymphology –…

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Testing the potential risk of developing chronic venous disease: Phleboscore®

Testing the potential risk of developing chronic venous disease: Phleboscore® Philippe BLANCHEMAISON, MD 113, avenue Victor Hugo, 75116-Paris, France Abstract Chronic venous disorders (CVD), a highly prevalent problem among populations worldwide, with which both general practitioners and specialists have to deal, include symptoms (leg pain, leg heaviness, and other types of discomfort) and signs as described in the Clinical, Etiological, Anatomical, and Pathophysiological (CEAP) classification. Symptoms appear early in the progression of the disease and with time may be associated with clinical signs of increasing severity. CVD is a chronic disorder that significantly alters the quality of life for the…

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Chronic venous disorders: pharmacological and clinical aspects of micronized purified flavonoid fraction

Chronic venous disorders: pharmacological and clinical aspects of micronized purified flavonoid fraction Arnaud MAGGIOLI 50 rue Carnot 92284 Suresnes, France Abstract Micronized purified flavonoid fraction (MPFF) is a flavonoid-based venoactive drug that is more potent than pure diosmin due to the presence of additional flavonoids, such as hesperidin, diosmetin, linarin, and isorhoifolin. In addition, the dissolution and absorption rates of MPFF increase due to the micronization of its active ingredients. The micronization process improves exposure to MPFF– derived metabolites that are responsible for its pharmacological activity. The positive impact of micronization on the pharmacological activity of purified flavonoid fraction has…

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An update on operative treatments of primary superficial vein incompetence: part 2.

An update on operative treatments of primary superficial vein incompetence: part I. Michel Perrin, MD Vascular Surgery, Unité de Pathologie Vasculaire Jean Kunlin Chassieu, France Abstract In part 2 of “An update on operative treatment of primary superficial vein incompetence,” all randomized controlled trials (RCTs) published since 1990 on operative treatments of varicose veins were collected and the references were gathered in tables according to either the procedure used or the patient’s clinical status. Case series and meta-analyses were taken into account in this review when RCTs were not available. For more details regarding clinical or instrumental outcomes of the…

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Management of combined venous and lymphatic malformations

Management of combined venous and lymphatic malformations Raul MATTASSI, MD College of Applied Sciences, Director of the Department of Vascular Surgery and Center for Vascular Malformations, “Stefan Belov,” Clinical Institute Humanitas “Mater Domini,” Castellanza (Varese) Italy Abstract Vascular malformations are congenital vessel malformations that include one or more venous, lymphatic, or arteriovenous defects. Klippel-Trenaunay syndrome occurs when there is a combination of venous and lymphatic malformations in the limbs; however, the definition is still controversial. The 2013 international venous malformation consensus established that Klippel-Trenaunay syndrome is a combination of venous malformations that involve the whole limb and lymphatic malformations. Although,…

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