Servier – Phlebolymphology

In his talk, the President of International Union of Phlebology presented the history of the organization, which was formed in 1959 by members of the Société Française de Phlébologie, Phlebological Association of Italy, Deutsche Arbeitsgemenschaft fur Phebologie, and Benelux Society of Phlebology. To date, the International Union of Phlebology includes a regional, national, and multinational conglomerate of 67 professional organizations with an interest in the professional study and treatment of patients with venous and lymphatic disorders, in sharing information, and in groundbreaking applications of science, pharmacology, and medical device innovation available worldwide in venous disease. The main roles of the organization are to strengthen the link between international member societies that have a special interest in venous and lymphatic disorders, to promote recommendations on the teaching of phlebology and the training and continuing medical education of phlebologists, to develop a consensus on all aspects of venous and lymphatic disorders, and to encourage clinical and basic research on these topics. Furthermore, the International Union of Phlebology aims to promote regional, national, and international congresses in order to foster the exchange of information among phlebology communities, to encourage creation and activities of national societies, and to encourage these entities to join in the effort to enhance the exchange of scientific information and innovation on a global scale through the International Union of Phlebology.

A number of challenges face the phlebology community and the executive leadership of the society has recognized several issues that are inhibiting the global potential of the International Union of Phlebology, including the perceived impact of the relationship of International Union of Phlebology with individual member societies, the uneven scientific quality and financial performance of International Union of Phlebology World Congresses and Chapter Meetings, the absence of a quantifiable understanding of the effect that the venous disease patient population has on a global scale, the need for greater mobilization and coordination of phlebology information and resources on an international level to promote a worldwide understanding of venous disease and its impact. To pursue the goals of the International Union of Phlebology more effectively, it is mandatory to enhance the available financial and administrative resources to ensure a direct and measurable impact on the global phlebology community and on the care available to patients with venous disease globally. For these purposes, Nick Morrison submitted two interdependent projects to the General Council: the first one is to restructure the International Union of Phlebology and the second is to create a partner organization (the International Union of Phlebology foundation), which would be solely dedicated to mobilizing, pursuing, and generating financial resources that can be dedicated to the global pursuit of advancing the treatment of venous disease through international investment in education and research.

The General Secretary of the International Union of Phlebology presented an overview of the scientific activity of the organization; in the last few years, 14 consensus documents have been published, which have had a remarkable impact on the scientific community. Furthermore, five International Union of Phlebology Consensus projects, relating to foam sclerotherapy, contraindications to sclerotherapy, rehabilitation in venous diseases, venous mapping, and pelvic venous insufficiency, are still ongoing. Finally, the missions for the future were illustrated; among these, the most important could be pursuing industry-funded research grants, creating a scientific standardization chair, and developing and founding a scientific agenda for the International Union of Phlebology. Potential projects of international importance could be the development of a scoring instrument for postthrombotic syndrome, the redaction of international clinical practice guidelines, and the creation of an international venous registry.

For phlebology, the 20th century was marked by surgery for large varicose veins, sclerotherapy for small veins and telangiectasias, and a clinical approach to the unknown. In the 21st century, phlebology crossed the portal of science; it is no longer an empiric part of medicine. Epidemiological studies showed a high incidence of venous pathology in all its forms and the high economic and social burden of venous disease. The old venous anatomy based on cadaveric and surgical remarks was enriched by new knowledge due to ultrasound assessments. An ultrasound assessment allows us to evaluate not only the anatomy, but also the hemodynamics. The clinical, etiological, anatomical, pathophysiological (CEAP) classification was developed, and it is still being updated. Consensus documents, guidelines, and good practice recommendations now provide international support for doctors worldwide about the main procedures in venous disease. A new era has dawned in the management of varicose veins with new technologies, such as endovenous laser therapy, radiofrequency ablation, steam ablation, mechanochemical ablation, glue, etc. In addition, minimally invasive procedures were developed. However, old challenges remain for postthrombotic syndrome, venous ulcers, and venous/lymphatic malformations.