Phlebolymphology N°83 – Editorial
In this new issue, Oscar Maleti and Marzia Lugli from Modena, Italy and Michel Perrin from Lyon, France present an excellent update on the very important clinical issue of postthrombotic syndrome after operative treatment. This disease can lead to severe chronic venous insufficiency in a significant number of cases due to postthrombotic deep vein obstruction and/or incompetence. Management of this disease is difficult and needs to be standardized. The most frequent combination is iliac obstruction and infrainguinal reflux. This paper presents a useful diagnostic and therapeutic strategy that can combine proximal recanalization and stenting with antireflux surgery. Currently, for the authors, four techniques for treating deep reflux are theoretically possible. They favor, in order, valvuloplasty, vein transposition, neovalve construction, and valve transplant as treatments for deep vein reflux.
Andre Cornu-Thenard and Pierre Boivin from Paris, France provide an interesting overview on pregnancy and chronic venous disease. The authors summarized the diagnosis and treatment of this disease in this special situation.
From Belorussia, we have received a contribution from Vyacheslav Yanushko, Alexander Bayeshko, Sergey Sushkov, Yuriy Nebylitsyn, and Alexander Nazaruk. They studied the benefits of Micronized Purified Flavonoid Fraction (MPFF) on primary chronic venous disease-related symptoms and quality of life in the DELTA study. This trial, with a large number of patients enrolled (522), concluded that simplicity of use, the universal nature of the standard dose, and good tolerance allows MPFF to be recommended for widespread usage in the everyday practice of physicians and general practitioners.
The article by Peter Neglén et al relates to the holding of the fifth EVF HOW (European Venous Forum Hands-on Workshop on Venous Disease) to be organized in Cyprus between October 30 and November 1 2014. The concept of a hands-on workshop on venous disease meets the major objectives of the European Venous Forum, which aims to develop and provide education within the venous field. The goal is not only to provide understanding of modern practical management, but also for the delegates to learn hands-on individual procedures to treat venous disease. The workshop targets those who want an introduction to or need an update on the management of venous disease. The intention is to give a wide learning on all aspects of acute and chronic venous diseases. Such an initiative to enhance the education of young specialists is to be encouraged. This is why the description of the last EVF HOW is published in the present issue.
Michel Perrin also presents another paper in this issue about the intriguing problem of the presence of varices after operative treatment (PREVAIT). This interesting review will be presented in two parts that will be published consecutively in the journal.
Finally, the present issue contains a new rubric consisting in comments on recent publications by: (i) Ramesh Tripathi, India (ii) Djordje Radak and Srdjan Babic from Serbia and ; (iii) Javier Leal-Monedero, Spain.
Enjoy reading this issue!
Fidel Fernández, Granada, Spain