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Postthrombotic syndrome is a frequent and fascinating problem, which is still not fully understood. Severe clinical consequences, especially recalcitrant leg ulcers, are a considerable burden both for the patient and for the general health care budget.
As Michel Perrin, Lyon, points out in his article, most patients with postthrombotic syndrome are treated conservatively, and duplex ultrasound is sufficient for diagnosis. However, in recent years various surgical and endoscopic techniques have been developed in specialized centers to improve deep venous hemodynamics, and this requires more detailed information before and after such procedures. The first article in this issue of Phlebolymphology offers a kind of checklist of information that be gathered by various investigations and used to tailor treatment to the individual patient.
Waldemar Olszewski from Warsaw, one of the leading pioneers in clinical lymphology, gives us some insight into his admirable work, which has considerable practical importance. He makes us keen to learn how much pressure is needed to move fluid effectively into nonlymphedematous regions of the body.
Chronic pelvic pain due to pelvic congestion syndrome can be relieved by the administration of Daflon 500 mg, as shown in two small, but carefully performed, randomized controlled trials, presented by Omur Taskin and co-workers from Antalya, Turkey.
Jean-Luc Gillet, Bourgoin-Jallieu, France, presents a review of practical importance on how patients presenting with recurrent varicose veins should be investigated by duplex.
Two very informative reports on recent publications end this issue. The first deals with a useful catalogue containing definitions of phlebological terms, drawn up by an international consensus group, for which Bo Eklof and Michel Perrin were the driving forces. The second is on the Handbook of Venous Disorders, the bible of the American Venous Forum. Phlebologists who wish to explore things in greater depth will certainly want to own these two publications.
Enjoy your reading!.
Hugo Partsch, MD