Servier – Phlebolymphology

The American Chapter Meeting of the Union Internationale de Phlébologie (UIP) was held in San Diego from August 27 to 30, 2003, under the aegis of the American College of Phlebology and with the participation of many other scientific societies from all over the World. On this occasion, The American Venous Forum held its symposium on ”Guidelines on the Management of Venous Disorders” (see part 6 of the present report). Many countries were represented, and this was a major opportunity to compare experiences from different continents. In contrast to previous meetings, no more than four sessions ran in parallel, so that more time could be given to each topic. Attention was focused on new techniques that are in rapid progression, and that will drastically change our views and habits in the phlebology field. In particular, the increasing use of foam sclerotherapy and various endovenous closure procedures, rather than previously accepted surgical stripping, is becoming evident. These less invasive methods that allow extension of treatment to older people were thoroughly explored by different teams who shared their interesting experience with all attendees during the congress. Also, the results of large-scale epidemiological studies, such as the Bonn Vein study, the Sao Paulo study, and the fourth part of the Bochum study, were presented. Most of these studies used the CEAP classification that is now universally adopted and allowed comparison. We learned of important findings in the schoolchildren of Bochum, particularly that detection of reflux usually precedes the clinical appearance of varicose veins, and that early detection of reflux in superficial veins may offer opportunities for preventive measures. New insight into the pathophysiology of venous disease was provided by different teams. The central role of the venous endothelium has been highlighted, and changes in endothelial activity of patients with venous disease have been observed. Effective pharmacological agents have been found to stabilize the endothelial cells at the level of large veins, and even, in the case of one of the most representative phlebotropic drugs, to act at the level of the capillary endothelium, thus accelerating leg ulcer healing. Other sessions dealt with risk factors for venous disease, compression therapy, and also superficial and deep venous disease. A special mention is to be given to the UIP initiatives and awards, with the presentation of different projects and research works. Prof Schultz-Ehrenburgh was awarded the first prize for scientific studies by the American College of Phlebology for his papers on the Bochum study (I to IV).
As President of the UIP, I find it of utmost importance that all the scientific presentations of the San Diego congress remain available, not only for those who attended all sessions, but also for those who were not present. In this special issue, much information will be available on the many presentations, thanks to the report by the team of the Medical Reporters’ Academy, initiated by Servier International.
This team, chaired by Andrew Nicolaides, has selected a large amount of information. I do welcome this excellent initiative, and I wish you interesting reading.