Update on treatment methods for telangiectasia

Mesut ENGIN, MD, Assoc Prof; University of Health Sciences, Bursa Yuksek Ihtisas Training and Research Hospital, Department of Cardiovascular Surgery, Turkey Abstract Telangiectasias make up a heterogeneous group of diseases that can affect various parts of the body in humans. Although generally limited to the face, telangiectasia can cover different parts of the body in various collagen tissue diseases. The appropriate treatment options for telangiectasias are sclerotherapy, laser therapy, thermocoagulation, and microphlebectomy. The purpose of sclerotherapy is to cause endothelial damage by injecting a sclerosing agent into the vascular bed. Agents such as polidocanol, sodium tetradecyl sulfate, hypertonic saline, and…

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Management of venous ulceration (interventional treatments) with perspectives from a recent meta-analysis and recommendations

Nicolas NEAUME, MD Clinique Pasteur, Toulouse, France Abstract Venous leg ulcers still affect about 1% of the adult population despite recent advances in chronic venous insufficiency treatment, and they represent a significant public health cost, estimated at between 1% and 2% of the annual health budget of Western European countries. Venous leg ulcers may be treated conservatively, with compression bandaging and wound care, medically, surgically, or with a combination of approaches, depending on the severity of the ulcer and available resources. The randomized trial of early endovenous ablation in venous ulceration demonstrated that early removal of a superficial venous reflux…

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Anticoagulation and interventional treatment of varicose veins

Matthieu JOSNIN, MD Saint Charles Clinic, Interventional Phlebology Unit, La Roche-sur-Yon, France Abstract Venous thromboembolic risk is very low after varicose vein procedures. This risk is often cited as less than 1%; however, studies also show the risk to be highly variable. Overall, literature in the field does not typically conclude thromboprophylaxis to be necessary in low-risk patients, owing to the low incidence of the event studied and the often-insufficient number of patients included. Despite the low incidence, venous thromboembolic risk is important in terms of mortality and morbidity. Varicose veins affect an average of 1 in 3 individuals, and…

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How to manage complications after sclerotherapy

Lourdes REINA Head of the Department of Vascular Surgery, Hospital Central de la Cruz Roja, Madrid, Spain Abstract Sclerotherapy is an effective and safe treatment when used by trained and careful hands. Good technique, satisfactory imaging, general precautions, and compliance with post treatment instructions may help avoid some of the adverse events. Even though complications can happen even to the most experienced practitioner, it is mandatory to know what they are and how to manage them. Fortunately, most of these adverse events are benign, but physicians must be aware of the potential serious events, and they should be trained to…

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An update on operative treatments of primary superficial vein incompetence: part 2.

An update on operative treatments of primary superficial vein incompetence: part I. Michel Perrin, MD Vascular Surgery, Unité de Pathologie Vasculaire Jean Kunlin Chassieu, France Abstract In part 2 of “An update on operative treatment of primary superficial vein incompetence,” all randomized controlled trials (RCTs) published since 1990 on operative treatments of varicose veins were collected and the references were gathered in tables according to either the procedure used or the patient’s clinical status. Case series and meta-analyses were taken into account in this review when RCTs were not available. For more details regarding clinical or instrumental outcomes of the…

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Sclerotherapy in the patient with diabetes: indications and results

Francesco FERRARA and Giovanni FERRARA Studio Flebologico Ferrara, Acerra, Naples, Italy ABSTRACT Goal: To assess the effects of combined compression and sclerotherapy treatment on varicose veins in patients with diabetes. Materials and methods: We evaluated 60 lower limbs with varicose veins from people with diabetes who underwent one session of sclerotherapy according to Sigg’s method. Varices were associated with reflux along the length of the great saphenous vein in 47 limbs, in the small saphenous vein in 8 limbs, and with nonsaphenous reflux in 5 limbs. Efficacy was determined by clinical and duplex scan examinations performed at 6, 8, and…

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Review and Comment of the 2011 Clinical Practice Guidelines of the Society for Vascular Surgery and the American Venous Forum

Gloviczki P, Comerota AJ, Dalsing MC, et al. The care of patients with varicose veins and associated chronic venous diseases: Clinical practice guidelines of the Society for Vascular Surgery and the American Venous Forum. J Vasc Surg. 2011;53:2S-48S. Marzia LUGLI Modena, Italy Oscar MALETI Modena, Italy Michel PERRIN Lyon, France ABSTRACT The Clinical Practice Guidelines of The Society for Vascular Surgery and The American Venous Forum, published in the 2011 Journal of Vascular Surgery supplement, is the most complete document on the management of varicose veins ever published in English. It is the work of leading members of the American…

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