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History of Venous Surgery (3) ...PAGE 59 12_DN_1028_BA_COUV_09_DN_020_BA_COUV 13/02/12 14:50 PageC1 ISSN 1286-0107 Vol 19 • No.2 • 2012 • p57-104 History of venous surgery (3) . PAGE 59 Michel PERRIN (Lyon, France) Factors to identify patients at risk for . PAGE 68 progression of chronic venous disease: have we progressed? Mieke FLOUR (Leuven, Belgium) Benefit of Daflon 500 mg in the reduction . PAGE 79 of chronic venous disease–related symptoms Maja LENKOVIC (Rijeka, Croatia) Pelvic vein incompetence: . PAGE 84 a review of diagnosis and treatment Giuseppe ASCIUTTO (Malmö, Sweden) Randomized controlled trial in the treatment . PAGE 91 of varicose veins Bo EKLÖF (Helsingborg, Sweden) and Michel PERRIN (Lyon, France) 12_DN_1028_BA_COUV_09_DN_020_BA_COUV 13/02/12 14:50 PageC2 AIMS AND SCOPE Phlebolymphology is an international scientific journal entirely devoted to venous and lymphatic diseases. Phlebolymphology The aim of Phlebolymphology is to pro- vide doctors with updated information on phlebology and lymphology written by EDITOR IN CHIEF well-known international specialists. H. Partsch, MD Phlebolymphology is scientifically sup- Professor of Dermatology, Emeritus Head of the Dermatological Department ported by a prestigious editorial board. of the Wilhelminen Hospital Phlebolymphology has been pub lished Baumeistergasse 85, A 1160 Vienna, Austria four times per year since 1994, and, thanks to its high scientific level, was included in several databases. Phlebolymphology comprises an edito- EDITORIAL BOARD rial, articles on phlebology and lympho- logy, reviews, news, and a congress C. Allegra, MD calendar. Head, Dept of Angiology Hospital S. Giovanni, Via S. Giovanni Laterano, 155, 00184, Rome, Italy P. Coleridge Smith, DM, FRCS CORRESPONDENCE Consultant Surgeon & Reader in Surgery Thames Valley Nuffield Hospital, Wexham Park Hall, Wexham Street, Wexham, Bucks, SL3 6NB, UK Editor in Chief Hugo PARTSCH, MD Baumeistergasse 85 M. De Maeseneer, MD 1160 Vienna, Austria Department of Dermatology, Tel: +43 431 485 5853 Fax: +43 431 480 0304 Erasmus Medical Centre, BP 2040, 3000 CA Rotterdam, Netherlands E-mail: [email protected] A. Jawien, MD, PhD Editorial Manager Department of Surgery Françoise PITSCH, PharmD Servier International Ludwik Rydygier University Medical School, 35, rue de Verdun Ujejskiego 75, 85-168 Bydgoszcz, Poland 92284 Suresnes Cedex, France Tel: +33 (1) 55 72 68 96 G. W. Schmid Schönbein, MS, PhD Fax: +33 (1) 55 72 56 86 E-mail: [email protected] Professor of Bioengineering and Medicine The Whitaker Institute for Biomedical Engineering, Publisher University of California San Diego, Les Laboratoires Servier 9500 Gilman Drive, La Jolla, CA 92093-0412, USA 50, rue Carnot 92284 Suresnes Cedex, France Tel: +33 (1) 55 72 60 00 Fax: +33 (1) 55 72 68 88 EDITORIAL MANAGER F. Pitsch, PharmD Servier International Indexed in EMBASE, PASCAL, Index Copernicus, and Scopus. © 2012 Les Laboratoires Servier - All rights reserved throughout the world and in all languages. No part of this publication may be reproduced, transmitted, or stored in any form or by any means either mechanical or electronic, including photocopying, recording, or through an information storage and retrieval system, without the written permission of the copyright holder. Opinions expressed do not necessarily reflect the views of the publisher, editors, or editorial board. The authors, editors, and publisher cannot be held responsible for errors or for any consequences arising from the use of the information contained in this journal. ISSN 1286-0107 12_DN_1028_BA_int_ok_Daflon_DEF_int_ok_Phlebo 22/02/12 16:47 Page57 CONTENTS EDITORIAL Hugo PARTSCH (Vienna, Austria) Page 58 PHLEBOLOGY History of venous surgery (3) Page 59 Michel PERRIN (Lyon, France) Factors to identify patients at risk for progression Page 68 of chronic venous disease: have we progressed? Mieke FLOUR (Leuven, Belgium) Benefit of Daflon 500 mg in the reduction Page 79 of chronic venous disease–related symptoms Maja LENKOVIC et al. (Rijeka, Croatia) Pelvic vein incompetence: a review of diagnosis Page 84 and treatment Giuseppe ASCIUTTO (Malmö, Sweden) Randomized controlled trial in the treatment Page 91 of varicose veins Bo EKLÖF (Helsingborg, Sweden) and Michel PERRIN (Lyon, France) CONGRESS Congress and conference calendar Page 100 Note from the Editorial Manager. The two latest issues were erroneously numbered (respectively, Vol 19 (4) and Vol 20 (1), instead of Vol 18 (4) and Vol 19 (1)). The present issue reverts to the correct numbering. Phlebolymphology. Vol 19. No. 2. 2012 57 12_DN_1028_BA_int_ok_Daflon_DEF_int_ok_Phlebo 22/02/12 16:47 Page58 EDITORIAL Dear Readers, This very special issue of Phlebolymphology contains review articles providing a wealth of information that is rarely found in textbooks or in journals. Hugo Partsch Much more than a look back at the historical developments of venous surgery, Editor in Chief the third and last chapter of the “history of venous surgery” written by Michel Perrin is a comprehensive and beautifully illustrated article on the state of the art of modern venous surgery and its role in deep venous disease. The reader will surely sense that this subject is still very close to the heart of the author, who worked in this field for many years and was one of its early pioneers. Mieke Flour, from the University of Leuven in Belgium, has written a fantastic review on a complex issue of high clinical relevance: the identification of risk factors for the progression of venous disease. Since longitudinal studies focusing on the spontaneous course of venous pathology are widely lacking, this subject is of the utmost importance to the evaluation of the long-term outcome of different treatment regimes. In a fascinating and comprehensive article, the author leads us from clinical and hemodynamic risk factors to genetic and racial factors, including gene polymorphism, and then on to the biomarkers that characterize inflammation and endothelial dysfunction. Apart from the very nice picture of the author, the article contains no illustration; however, it provides a bunch of very relevant and carefully selected references. Maja Lenkovic, from the Dermatological University Clinic in Croatia, reports on the clinical effects of Daflon 500 mg in patients with various venous disorders. A total of 1212 patients were enrolled in this open trial, including 115 patients with recurrent or recalcitrant leg ulceration, of which 13% were healed after 6 months of adjunctive treatment with Daflon 500 mg. Giuseppe Asciutto from the University Hospital Malmö-Lund, Sweden, reviews the clinical aspects, etiology, diagnosis, and treatment options for pelvic vein incompetence, an often underestimated clinical entity that has gained interest in everyday practice. Spanish pioneers like Leal Monedero and Zubicoa are not mentioned in the long reference list because— unfortunately—they do not publish in English. However, their work was included in the interesting article written by J.F. van Cleef, published in Phlebolymphology in the first issue of 2011. Lastly, to conclude this issue of Phlebolymphology, a joint article by Bo Eklöf, Sweden, and Michel Perrin, France, contains the second part of the overview on “randomized controlled trials in the treatment of varicose veins.” (The first part was published in the last issue of Phlebolymphology). What great work, so much more instructive than any meta-analysis! Enjoy your reading! 58 Phlebolymphology. Vol 19. No. 2. 2012 12_DN_1028_BA_int_ok_Daflon_DEF_int_ok_Phlebo 22/02/12 16:47 Page59 PHLEBOLOGY History of venous surgery (3) This is the last of the 3 chapters that make up a “History of Venous Surgery.” In the previous issues of Phlebolymphology (Vol. 18, no. 3 and no. 4, 2011), an overview was presented of varicose vein surgery from the ancient Egyptians to the 20th century. In the present issue, the history continues with venous surgery other than varicose vein surgery. Michel PERRIN Venous surgery other than varicose vein surgery Vascular surgery, TREATMENT OF DEEP VEIN THROMBOSIS OF THE LOWER Lyon, France AND UPPER LIMBS DURING THE ACUTE PHASE. Lower limbs 1. Thrombectomy Thrombectomy is the resection of a blood clot and was the first surgical procedure performed in the treatment of acute deep vein thrombosis (Figure 21). In the lower limb, this procedure is attributed to the German surgeon Läwen in 1937. In principle, thrombectomy has three objectives: prevention of pulmonary embolism, treatment of the thrombosis itself, and prevention or limiting of sequelae, and postthrombotic syndrome. Combined with anticoagulant therapy, which made it possible, but also in competition with it, thrombectomy was recommended in France by Leriche, and then Fontaine, after the Second World War. It was favorably received by a few surgical teams, but did not enjoy total support by all vascular specialists. Subsequently, Figure 21. Thrombectomy of the iliac because of the availability of medical venous axis with a Fogarty catheter therapies and new techniques, the Source: Perrin M, Nicolini P. Traitement des objectives of thrombectomy were thromboses veineuses profondes des membres inférieurs par fibrinolyse in situ et thrombectomie. Keywords: called into question. EMC (Elsevier Masson SAS, Paris), Techniques aneurysm, history, obstruction, reflux, chirurgicales - Chirurgie vasculaire, 43-167, 2001. venous malformations, venous surgery, venous thrombosis 2. Fibrinolysis In fibrinolysis, a fibrinolytic agent is administered to a patient with a thrombosis and activates
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