Phlebolymphology N°56

Phlebolymphology N°56 (Vol 14 – N°3 – 2007)

EDITORIAL Editorial H. Partsch – Phlebolymphology – 2008 ; 15(1): 98 PHLEBOLOGY Advances in the surgical treatment of postthrombotic syndrome A. Puggioni, F. Lurie – Phlebolymphology – 2008; 15 (1): 99 Incompetent venous valves: ultrasound imaging and exo-stent repair R. J. Lane, J. A. Graiche – Phlebolymphology – 2008; 15 (1): 105 SERVIER FELLOWSHIP Exchanges between European and American physicians: the first American Venous Forum, Servier Traveling Fellowship C. E. Stonerock – Phlebolymphology – 2008; 15 (1): 116 LYMPHOLOGY Erysipelas and lymphedema L. Vaillant – Phlebolymphology – 2008; 15 (1): 120 PHLEBOLOGY Premenstrual symptoms in lower limbs and Duplex scan…

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Phlebolymphology N°56 – Editorial

Dear Readers, Several problems of considerable clinical importance are discussed in this issue of Phlebolymphology. A paper from Hawaii, written by Alessandra Puggioni and Fedor Lurie, gives an update on surgical options for the treatment of obstruction and reflux in the deep venous system that cause postthrombotic syndrome. The discrepancy between the high incidence of the disease (3/1000 per year in the adult population) and the low number of surgical procedures reported in the literature raises the suspicion that there is still no ideal and standardized method that can be performed in a wide range of settings. However, superficial reflux…

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Exchanges between European and American physicians: the first American Venous Forum, Servier Traveling Fellowship

Charles E. STONEROCK South Carolina, USA Report from Charles E. Stonerock (Indianapolis, USA), winner of the 2006 AVF/Servier Fellowship BONJOUR MESDAMES ET MESSIEURS, My name is Charles Stonerock and I have recently completed a Peripheral Vascular Surgery Fellowship at Indiana University, Indianapolis, IN. I have been fortunate enough to have been awarded the Servier Traveling Fellowship for my work in Deep Venous Thrombosis Diagnosis last year and would like to give an update of my experiences, and how they have changed my current practice of medicine. The Servier Traveling Fellowship was established to promote better communication and understanding on the…

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Quantification of microangiopathy in chronic venous disease

C. E. VIRGINI-MAGALHÃES, C. L. LASCASAS PORTO, F. F. A. FERNANDES, D. M. DORIGO, D. A. BOTTINO, E. BOUSKELA Laboratory for Research in Microcirculation, State University of Rio de Janeiro, Rio de Janeiro, RJ, Brazil ABSTRACT Analysis of microcirculatory changes in chronic venous disease (CVD) is challenging because we lack practical tools. The orthogonal polarization spectral (OPS) imaging technique used in the Cytoscan is less than ten years old and seems to be suitable for studying patients suffering from CVD. The Cytoscan has a small handheld probe which can be noninvasively applied to all body surfaces. CVD was studied using…

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Advances in the surgical treatment of postthrombotic syndrome

Alessandra PUGGIONI* and Fedor LURIE** * Marco Polo Fellow of the Society for Vascular Surgery, year 2007 ** Department of Surgery, John A. Burns School of Medicine, University of Hawaii ABSTRACT Postthrombotic syndrome (PTS) is the late complication of lower extremitiy deep venous thrombosis (DVT). Its incidence is approximately 3/1000 per year in the adult population. A combination of reflux and obstruction is often seen in limbs with more advanced clinical disease than obstruction alone. A thorough workup of the patient with disabling PTS is necessary to identify patients amenable to open surgical or endovascular intervention. Duplex scanning is the…

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Incompetent venous valves: ultrasound imaging and exo-stent repair

Rodney James LANE1-3 Joseph Anthony GRAICHE1 Michael Luciano CUZZILLA1 John Christopher CORONEOS1-3 1 Dalcross Private Hospital 2 Mater Private Hospital 3 North Shore Private Hospital Sydney, AUSTRALIA SUMMARY Background: Lower limb venous disease remains a significant problem in our community today. The condition has been treated mainly with ablative procedures such as stripping and/or sclerotherapy. The aim of this study was to assess external valvular stenting (EVS) of incompetent venous valves as a reparative alternative to the management of patients with varicose veins. In addition, ultrasound examination of the superficial venous valves prior to surgery was also assessed for its…

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Erysipelas and lymphedema

Loïc VAILLANT Skaraborg Université François Rabelais, Tours, France SUMMARY Erysipelas is a nonnecrotizing bacterial hypodermal cellulitis usually associated with streptococcal infection. It may be a mainly secondary complication of chronic lymphedema, and occurs in 20% to 30% of cases. The first presenting signs are sudden fever and shivering. The clinical feature is inflammatory plaque, which is often chronic and accompanied by fever. Inflammatory plaque is promoted by lymph stasis, and is marked by inflammatory episodes that often regress spontaneously. Erysipelas per se is mainly treated with antibiotics, and adjuvant therapies are not justified. The prevention of recurrence is primary. Since…

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Premenstrual symptoms in lower limbs and Duplex scan investigations

Jerry G. NINIA Clinical Associate Professor SUNY – Stony Brook School of Medicine ABSTRACT Objectives: Approximately 40% of menstruating women experience luteal phase symptoms that are bothersome. Although the distinguishing characteristic is irritability, symptoms typically are a mix of cognitive and physical disturbances. Leg swelling and discomfort are one such physical symptom. The goal of the study is to define the clinical entity of a late luteal phase vasodilation syndrome in symptomatic patients. Methods: Duplex venous scans were performed in the standing position on 12 premenopausal women (age range 19-46 years) who described premenstrual symptoms of bilateral leg swelling, pressure,…

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