VEIN STEP: Chronic VEnous dIsorders maNagement and Treatment Effectiveness Evaluation in Chronic Venous Disease, an International Observational Prospective Study. Results from Morocco

Tazi Mezalek ZOUBIDA, MD1,2 Jorge Hernando ULLOA, MD, FACS3 1Faculty of Medicine and Pharmacy, Mohammed V University, Rabat, Morocco; 2Clinical Hematology Department, Ibn Sina University Hospital, Rabat, Morocco; 3Fundacion Santa Fe de Bogota, Bogota, Colombia Abstract Aim: VEIN STEP is an international, observational, prospective study assessing the effectiveness of conservative treatments for the relief of chronic venous disease (CVD) symptoms and their impact on quality of life (QOL). This article presents results collected in Moroccan patients. Method: Adult outpatients consulting for symptomatic CVD were categorized via the Clinical, Etiological, Anatomical, Pathophysiological (CEAP) classification system. Intensity of symptoms and their improvement…

Full text

Course duration for venoactive-drug treatment in chronic venous disease

Roman KALININ, MD, PhD, DMedSc; Igor SUCHKOV, MD, PhD, DMedSc; Aleksey KAMAEV, MD, PhD; Nina MZHAVANADZE, MD, PhD. MD Department of Cardiovascular, Endovascular, Operative Surgery and Topographic Anatomy, Ryazan State Medical University, Ryazan, Russia Abstract Chronic venous disease (CVD) is currently the most common vascular disorder of the lower extremities. The gradual progression of CVD has a negative impact on patients and also leads to high economic costs of medical care, especially for the advanced forms of chronic venous insufficiency (CVI). Conservative management of CVD includes the use of compression stockings and pharmacological therapy. Despite the efficacy of compression therapy,…

Full text

Risks and contraindications of medical compression treatment

Eberhard RABE, MD1; Felizitas PANNIER, MD2 1Private practice, Helmholtzstr. 4, Bonn, Germany 2Private practice, Helmholtzstr. 4, Bonn, Germany and Department of Dermatology, University of Cologne, Germany Background Medical compression treatment with medical compression stockings (MCS), compression bandages (CB), or intermittent pneumatic compression (IPC) belongs to the basic treatment options in acute and chronic venous diseases and in lymphedema. In a recent international consensus paper, well-known experts in the field reviewed the recent literature on reported risks and recommended contraindications for elastic compression treatment. Results: Reported nonsevere adverse events (AEs) included skin irritation, allergic skin reaction, discomfort and pain, forefoot edema…

Full text

Phlebolymphedema: is it a new concept?

Byung-Boong LEE, MD, PhD, FACS Professor of Surgery and Director, Center for the Lymphedema and Vascular Malformations, George Washington University, Washington DC, USA Abstract Venous and lymphatic systems are inseparable “dual” outflow systems with mutually complimentary function so that such mutual interdependence between these two systems causes a new condition to affect both systems simultaneously when one of the two systems should fail to provide sufficient compensation to the other system, known as “phlebolymphedema” (PLE): combined condition of chronic venous insufficiency (CVI)/chronic venous hypertension and chronic lymphatic insufficiency (CLI)/chronic lymphedema. PLE is, therefore, an unavoidable outcome of the joint failure…

Full text

Micronized purified flavonoid fraction in adjunction to rivaroxaban improves outcomes of popliteal-femoral deep-vein thrombosis at 12-month follow-up

Kirill LOBASTOV,1 MD, PhD; Ilya SCHASTLIVTSEV,1,2 MD, PhD; Victor BARINOV,2 MD, PhD 1Pirogov Russian National Research Medical University, Moscow, Russian Federation; 2Clinical Hospital no.1 of the President’s Administration of the Russian Federation Abstract Aim: To assess the efficacy of the long-term use of micronized purified flavonoid fraction (MPFF) in the treatment of popliteal-femoral deep-vein thrombosis (DVT). Methods: In this pilot, comparative, open-label clinical study, patients with the first episode of popliteal-femoral DVT confirmed by duplex ultrasound scan (DUS) were allocated to two groups: the control group received standard treatment with rivaroxaban for 6 months and compression stockings for 12 months,…

Full text

Influence of age, gender, duration of illness, and symptoms on pigmentation/ulceration in varicose veins of the great saphenous system

Prasesh DHAKAL, MBBS; Robin Man KARMACHARYA, MS; Satish VAIDYA, MS; Amit Kumar SINGH, MS; Pratima THAPA, MBBS; Sushil DAHAL, MBBS; Niroj BHANDARI; Sohail BADE; Prabha SHRESTHA, MSN. Department of Surgery, Dhulikhel Hospital, Kathmandu University Hospital, Dhulikhel, Nepal Abstract Background: Venous pigmentation and ulceration in varicose veins pose significant financial and psychological burdens and affect quality of life. Not all varicose veins progress to this stage (C4-C6 in CEAP classification), and knowing the predictors for progressing to pigmentation/ulceration in varicose veins helps address high-risk patients early on. Materials and methods: This is a retrospective observational study done in patients diagnosed with…

Full text

Modeling and 3D printing of veins from CT venograms

Jean-Francois UHL, MD, FacPh of the UNESCO Chair of Digital Anatomy, Paris University Abstract Digital anatomy has more and more applications in medicine and surgery, thanks to the progress in imaging and power of computer software. To evaluate patients with chronic venous disorders, in the case of complex anatomy or recurrent varices after surgery (REVAS), three-dimensional (3D) modeling of the venous system is often a great support. A global 3D depiction of the whole venous morphology will help the hemodynamical mapping achieved by color Duplex ultrasound. In addition to anatomical information, color Duplex ultrasound also provides essential hemodynamic data for…

Full text

Combination therapy in the treatment of varices

Nicholas H. OSBORNE MD, MS1*; Craig BROWN MD, MS1; Christopher O. AUDU MD, PhD1; Danielle C. SUTZKO MD, MS2; Andrea T. OBI MD1; Thomas W. WAKEFIELD MD1 1Section of Vascular Surgery, Department of Surgery, Michigan Medicine; 2Division of Vascular Surgery and Endovascular Therapy, Department of Surgery, University of Alabama at Birmingham Abstract Background: There is significant variation in the treatment of combined truncal-vein reflux and symptomatic varicosities. We sought to use the Vascular Quality Initiative (VQI) Varicose Vein Registry (VVR) to explore the contemporary real-world experience of combined ablation and phlebectomy versus ablation alone. Methods: Using the VQI/VVR database, patients…

Full text

What is the best method of imaging in iliofemoral venous obstruction?

Gerard J. O’SULLIVAN MB, BCh, BAO, FRCR National University of Ireland, Galway, Ireland Abstract Iliofemoral venous obstruction is increasingly recognized as a major cause of post-thrombotic syndrome. Patients can be left with significant symptoms after just one episode of iliofemoral deep-vein thrombosis; ranging from milder problems, such as varicose veins, to itching, leg swelling, and even venous ulceration. With the advent of endovascular techniques to reconstruct the iliofemoral segment has come an understanding that accurate recognition and diagnosis form a central part of the puzzle. Clinical evaluation is limited, and imaging has assumed a central role. This article looks at…

Full text

Effectiveness of micronized purified flavonoid fraction–based conservative treatment in chronic venous edema

Vadim Yu BOGACHEV, MD, PhD On behalf of the VAP-PRO-C3 study investigators group. Department of Faculty Surgery No. 2, Pirogov Russian National Research Medical University (RNRMU), Moscow, Russia Abstract Aim: This study assessed the effectiveness of micronized purified flavonoid fraction (MPFF)-based conservative treatment in patients with chronic venous edema (CVE) as part of an observational program that evaluated the management of patients with CVE caused by the primary forms of chronic venous disease (CVD) in real clinical practice. Materials and methods. The VAP-C3 (Vein Act Prolonged-C3; NCT03722836) prospective, single-arm, observational study was conducted in Russia in adult outpatients with CVD…

Full text