aree scientifiche


Phlébologie 2002, 55, N° 1, 27 – 31

27) E CRIADO, J Juan, J Fontcuberta and J M Escribano: Haemodynamic surgery for varicose veins: rationale, and anatomic and haemodynamic basis

Phlebology Vol 18 No. 4 2003 pag 158-166

Abstract

The treatment of varicose veins has traditionally been ablative in nature and implemented without intent to improve the haemodynamic condition of the lower extremity veins. Haemodynamic surgery attempts to treat varicose veins by changing the reflux pattern while preserving the most efficient venous drainage channels. To implement this treatment modality it is necessary to have a clear understanding of the physiologic principles and the different reflux patterns that form the basis of haemodynamic surgery. Haemodynamic surgery is an emerging treatment for varicose veins, and has received little attention in the English literature. The rationale, and functional and anatomic basis of haemodynamic surgery for varicose veins are herein described.

28) J JUAN J M Escribano E Criado: Haemodynamic surgery for varicose veins: surgical strategy 

Phlebology 2005 Vol 20 No. 1 pag: 1-13

Abstract

The haemodynamic approach for the treatment of varicose veins is a minimally invasive, non-ablative procedure that preserves the saphenous vein. The strategic principles for the implementation of this treatment include fragmentation of the venous pressure column, interruption of the venous segments where reflux originates, preservation of the superficial venous outflow channels to allow adequate drainage of the residual superficial system, and excision of the superficial varicose veins that remain undrained. This treatment modality requires a thorough understanding of the haemodynamic and anatomic rationale on which haemodynamic surgery is construed to tailor a treatment plan individually for each patient. The principles for the implementation of this strategy for the treatment of varicose veins are described here and the results are discussed.

29) C FRANCESCHI C., Bahnini A.: Reponse a article-Mise au point concernant les commentaires sur la cure CHIVA dans l’article des Drs P. Pittaluga et S. Chastanet. Commentaire de P. Pittaluga.Phlebologie, 2008

30) F. PASSARIELLO: Suppression of the sapheno-femoral reflux by pure non-saphenous phlebectomy and anatomical structure of the reflux

ACTA PHLEBOL 2008;9:105-7

 Aim. Recently, several hypotheses on varicose veins origin were pro- posed. Accordingly, a non-saphenous foam procedure was shown to achieve successful results in the suppression of the sapheno- femoral reflux, being its persistence limited to a small percentage of treated cases. The aim of the present note is to illustrate the hemodynamic basis of these reflux suppressing failures. Methods. Two hemodynamic theoretic simulations were desi- gned to represent adequately this hemodynamic condition. The sapheno-femoral reflux can be classified according to Teupitz into two kinds of different shunts: ShI and ShIII. The abla- tion of the varicosity’s of the non-saphenous superficial network can achieve the disconnection of Sh III and VI, but in no way of Sh I. So that, if the main reflux is a ShI the sapheno-femoral reflux does not disappear after the phlebectomy.

Results. The thorough study of the patient’s cartography makes the choice of the surgical strategy easier and more precise. Conclusion. Depending on the structure of the reflux and as to immediate results, GSV ablation can sometimes solve comple- tely the varicose pathology, while in other cases it is completely unsatisfying.

31) C. FRANCESCHI C.: Hémodynamique de la maladie postphlébitique : conséquences diagnostiques et thérapeutiques 

Journal des Maladies Vasculaires 2008  Volume 33, numéro S1 

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