Servier – Phlebolymphology

This very special issue of Phlebolymphology contains review articles providing a wealth of information that is rarely found in textbooks or in journals.

Much more than a look back at the historical developments of venous surgery, the third and last chapter of the “history of venous surgery” written by Michel Perrin is a comprehensive and beautifully illustrated article on the state of the art of modern venous surgery and its role in deep venous disease. The reader will surely sense that this subject is still very close to the heart of the author, who worked in this field for many years and was one of its early pioneers.

Mieke Flour, from the University of Leuven in Belgium, has written a fantastic review on a complex issue of high clinical relevance: the identification of risk factors for the progression of venous disease. Since longitudinal studies focusing on the spontaneous course of venous pathology are widely lacking, this subject is of the utmost importance to the evaluation of the long-term outcome of different treatment regimes. In a fascinating and comprehensive article, the author leads us from clinical and hemodynamic risk factors to genetic and racial factors, including gene polymorphism, and then on to the biomarkers that characterize inflammation and endothelial dysfunction. Apart from the very nice picture of the author, the article contains no illustration; however, it provides a bunch of very relevant and carefully selected references.

Maja Lenkovic, from the Dermatological University Clinic in Croatia, reports on the clinical effects of MPFF at a dose of 500 mg in patients with various venous disorders. A total of 1212 patients were enrolled in this open trial, including 115 patients with recurrent or recalcitrant leg ulceration, of which 13% were healed after 6 months of adjunctive treatment with MPFF at a dose of 500 mg.

Giuseppe Asciutto from the University Hospital Malmö-Lund, Sweden, reviews the clinical aspects, etiology, diagnosis, and treatment options for pelvic vein incompetence, an often underestimated clinical entity that has gained interest in everyday practice. Spanish pioneers like Leal Monedero and Zubicoa are not mentioned in the long reference list because— unfortunately—they do not publish in English. However, their work was included in the interesting article written by J.F. van Cleef, published in Phlebolymphology in the first issue of 2011.

Lastly, to conclude this issue of Phlebolymphology, a joint article by Bo Eklöf, Sweden, and Michel Perrin, France, contains the second part of the overview on “randomized controlled trials in the treatment of varicose veins.” (The first part was published in the last issue of Phlebolymphology). What great work, so much more instructive than any meta-analysis!