Phlebolymphology N°96

VNUS Closure radiofrequency ablation to eliminate truncal venous reflux in patients with varicose veins: 15-year results

Mark S. WHITELEY 1The Whiteley Clinic, Stirling House, Stirling Road, Guildford, Surrey GU2 7RF, UK 2Faculty of Health and Biomedical Sciences, University of Surrey, Guildford, Surrey GU2 7XH, UK Abstract In 2017, we published our 15.4-year results on using VNUS Closure radiofrequency ablation on incompetent truncal veins. The original operations were performed between 1999 and 2001 using the method available at the time, ie, general anesthesia with Esmarch compression bandaging; no tumescence was used. Of 101 truncal veins analyzed, 89 (88%) were ablated successfully and 12 (12%) were ablated partially (partial failure) with reopening of the proximal stump and venous…

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VenaSeal™ closure system for varicose veins

Raghu KOLLURI OhioHealth, Riverside Methodist Hospital, Columbus, Ohio, US Abstract Endothermal treatments are now considered the new gold-standard treatment for eliminating venous reflux in patients with chronic venous insufficiency. In a quest to minimize the invasiveness, nonthermal techniques that do not require tumescent anesthesia have been developed in the last decade. These new nonthermal, tumescent-less techniques are well tolerated and result in equivalent outcomes compared with endothermal ablations. VenaSealTM, one such technique, utilizes a proprietary cyanoacrylate glue to occlude the saphenous vein. Studies using VenaSealTM have demonstrated high anatomic success rates with closure rates >90% reported at 3 years. Sustained…

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Small, structured workshops: an improved learning experience?

Peter NEGLÉN, MD, PhD1, Bo EKLÖF, MD, PhD2 1Vascular Surgeon, Trimiklini, Cyprus 2Professor Emeritus, Vascular Surgeon, Råå, Sweden Abstract The need to define a curriculum, instructional plan, and training for future phlebologists has been obvious for years. In 2017, the European Union of Medical Specialists approved the European Training Requirement (ETR) in phlebology, which outlined an instruction plan. Training practices included hands-on training using phantom limbs, demonstrations on live subjects, videos on procedures, case discussions, and attending “live” procedures. We believe that the European Venous Forum Hands-On Workshop (EVF HOW) shows a model of instruction that can meet the goals…

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State of art in lymphedema management: part 2

Byung-Boong LEE Professor of Surgery & Director, Center for Lymphedema and Vascular Malformation, George Washington University School of Medicine Abstract Chronic lymphedema can be managed effectively using a sequenced and targeted treatment program based on decongestive lymphatic therapy (DLT) with compression therapy and surgery (mostly as an adjunct to DLT). In the maintenance phase, DLT is carried out using the proper combination of compression garments, meticulous personal hygiene and skin care, self-massage based on the principle of manual lymphatic drainage (if applicable), and exercises and activities to promote lymph transport. Pneumatic compression devices and therapy can be applied at home,…

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The place of MPFF in the management of chronic venous disease

Andrew NICOLAIDES Emeritus Professor of Vascular Surgery, Imperial College, London, UK; Honorary Professor of Surgery, University of Nicosia Medical School, Cyprus; Director, Vascular Screening and Diagnostic Centre, Nicosia, Cyprus Abstract The aim of this review is to provide a clear understanding of the actions of the micronized purified flavonoid fraction (MPFF) at various pathophysiological stages of chronic venous disease (CVD), the mechanisms that underlie its efficacy, and the evidence for clinical applications for symptom relief, reversal of skin changes, healing of leg ulcers, and improving quality of life (QOL), with perspectives from the 2018 international guidelines. MPFF relieves symptoms, edema,…

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Phlebolymphology N°96 – Editorial

Dear Readers, In this new issue, Andrew Nicolaides (Cyprus) provides a clear understanding of the actions of micronized purified flavonoid fraction (MPFF) at various pathophysiological stages of chronic venous disease, the mechanisms that underlie its efficacy, and the evidence for clinical applications for symptom relief, reversal of skin changes, healing of leg ulcers, and improving quality of life, with perspectives from the 2018 international guidelines. He emphasizes that MPFF is strongly recommended for the treatment of pain, heaviness, feeling of swelling, functional discomfort, cramps, leg redness, skin changes, edema, and quality of life, as well as for the healing of…

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Phlebolymphology N°96 (Vol 25 – N°3 – 2018)

EDITORIAL Editorial PHLEBOLOGY The place of MPFF in the management of chronic venous disease Andrew NICOLAIDES (Cyprus) Phlebolymphology – 2018 ; 25 (3): 179 State of art in lymphedema management: part 2 Byung-Boong LEE (USA) Phlebolymphology – 2018 ; 25 (3): 189 Small, structured workshops: an improved learning experience? Peter NEGLÉN (Cyprus), Bo EKLÖF (Sweden) Phlebolymphology – 2018 ; 25 (3): 201 VenaSeal™ closure system for varicose veins Raghu KOLLURI (USA) Phlebolymphology – 2018 ; 25 (3): 207 VNUS Closure radiofrequency ablation to eliminate truncal venous reflux in patients with varicose veins: 15-year results Mark S. WHITELEY (UK) Phlebolymphology –…

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