Dialogue on venous hemodynamics

Oscar MALETI,1 MD: Fedor LURIE,2 MD, PhD; Giorgio BERGAMO,3 BSc; Sara GUERZONI,4 BSc; Marzia LUGLI,1 MD 1Vascular Surgery, Hesperia Hospital, Modena, Italy 2Jobst Vascular Institute and the Division of Vascular Surgery at the University of Michigan, Ann Arbor, Michigan, USA 3Microlab Elettronica Sas. Padova, Italy 4Fleboxan Vein Clinic, Modena, Italy Abstract Hemodynamics of the venous system of the lower limbs is very complex, its explanation typically evoking formulas and concepts that can be daunting for those new to the subject. Here, we approach the task from a more conversational angle, introducing a dialogue between expert and student as they discuss…

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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…

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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…

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Prevention and treatment of venous disorders during pregnancy and the postpartum period

Djordje RADAK1,2,3; Slobodan TANASKOVIC1,2 University Hospitals Leuven, Belgium Abstract Chronic venous disease represents one of the most frequent medical conditions that could be observed in the general population. Pregnancy is one of the major predisposing factors for developing venous insufficiency due to an enlarged gravid uterus, which obstructs pelvic venous outflow, and an increase in hormone secretion, which weakens the vein wall. A clinical examination and Doppler ultrasound evaluation are used to diagnose venous insufficiency during pregnancy; these clinical findings can vary from insignificant telangiectases to severe varicose veins and skin damage. The relative risk of a venous thromboembolism (VTE)…

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Testing the potential risk of developing chronic venous disease: Phleboscore®

Testing the potential risk of developing chronic venous disease: Phleboscore® Philippe BLANCHEMAISON, MD 113, avenue Victor Hugo, 75116-Paris, France Abstract Chronic venous disorders (CVD), a highly prevalent problem among populations worldwide, with which both general practitioners and specialists have to deal, include symptoms (leg pain, leg heaviness, and other types of discomfort) and signs as described in the Clinical, Etiological, Anatomical, and Pathophysiological (CEAP) classification. Symptoms appear early in the progression of the disease and with time may be associated with clinical signs of increasing severity. CVD is a chronic disorder that significantly alters the quality of life for the…

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Combined hormonal contraceptives and the subsequent risk of a venous thromboembolism

Combined hormonal contraceptives and the subsequent risk of a venous thromboembolism Christian Jamin Gynecologist Paris, France Abstract Recent public alarm in European countries has renewed concerns about the safety of oral contraceptive pills (OCPs) after women sued manufacturers for potentially fatal venous thromboembolisms resulting from using OCPs (particularly those combining estrogen and the new generations of progestin). Earlier studies, reporting an increased risk of venous thromboembolisms, produced conflicting results and had methodological limitations, calling into question the validity of the findings and conclusions about the magnitude of the additional risk associated with using the new progestin-containing contraceptives. Finally, the World…

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