Servier – Phlebolymphology

Dear Readers,
An interesting mixture of practically important and basic science articles can be found in this issue of Phlebolymphology. The management of venous thromboembolism during and after pregnancy is still widely based on experience because randomized controlled trials in this field are lacking for obvious reasons. Christine Biron-Andreani of the Hematology Unit of the University Hospital in Montpellier gives us a survey of practically very useful, updated recommendations, concerning both prevention and treatment of venous thromboembolic disease, in accordance with the recent ACCP guidelines and supported by numerous references. The choice of a proper wound dressing in venous leg ulcers has become an art. The article by Patricia Senet, Hôpital Tenon, Paris, offers a remarkable overview of local wound dressings on the market, including biological therapy, debridement, skin grafting, and topical negative pressure (VAC). The value of compression as a basic management modality is clearly underlined. In addition to these measures, reflux abolition of incompetent superficial veins by chemical or physical means can be very effective and has been proven to reduce the rate of recurrence. Our current understanding of the molecular regulation of lymphangiogenesis and its relevance to metastasis and survival of cancer patients is reviewed in a basic research article containing a very impressive list of references by Jonathan P. Sleeman, Medical University of Mannheim-Heidelberg. The therapeutic consequences of targeting tumor-associated lymphatic vessels are discussed. During recent years the subject of “patient-related outcomes” has gained considerable attention in the medical literature. Michael A. Vasquez and Carolyn E. Munschauer of Buffalo, NY, have supplied us with a nicely illustrated extended abstract of their original article published in Phlebology 2008 on “Venous Clinical Severity Score and Quality-of-Life Assessment Tools: Application to Vein Practice“. Besides generic instruments, like the SF-36 and the Nottingham Health Profile, disease-specific instruments (CIVIQ, VEINES, Aberdeen Venous Vein Questionnaire, and Charing Cross Venous Ulceration Questionnaire) are explained. A revision of the present Venous Clinical Severity Score (VCSS) is recommended. The issue ends with an informative book review written by Michel Perrin, Lyon, on vascular aneurysms. This book, dating back some years, was edited by Athanasios Giannoukas form Larissa, Greece, but is still very relevant to current practice.