aree scientifiche

ABSTRACT

The long term results of classic surgical treatment of varicose veins are not completely correspond to requirements of physicians and wishes of patients. The modern methods of varicose veins treatment include endovenous thermal or chemical ablation and “conservative” interventions (CHIVA, ASVAL). According to the literature review, these methods provide the high efficacy of treatment and are associated with low rate of complications and recurrence of disease. Widening of spectrum of curative methods contribute to the individualization of varicose veins treatment.

36) LARISSA PFISTERER, Gerd König, Markus Hecker, and Thomas Korff: 

Pathogenesis of varicose veins – lessons from biomechanics

VASA Volume 43 · Issue 2 · March 2014 pag: 88-99

Summary

The development of varicose veins or chronic venous insufficiency is preceded by and associated with the pathophysiological remodelling of the venous wall. Recent work suggests that an increase in venous filling pressure is sufficient to promote varicose remodelling of veins by augmenting wall stress and activating venous endothelial and smooth muscle cells. In line with this, known risk factors such as prolonged standing or an obesity-induced increase in venous filling pressure may contribute to varicosis. This review focuses on biomechanically mediated mechanisms such as an increase in wall stress caused by venous hypertension or alterations in blood flow, which may be involved in the onset of varicose vein development. Finally, possible therapeutic options to counteract or delay the progress of this venous disease are discussed.

Key words: Varicose veins, shear stress, circumferential wall tension, endothelial cells, vascular smooth muscle cells, remodelling

37) GIANESINI S, Occhionorelli S, Menegatti E, Zuolo M, Tessari M, Spath P, Ascanelli S, Zamboni P.: CHIVA strategy in chronic venous disease treatment: instructions for users.

Phlebology. 2015 Apr;30(3):157-71

Abstract

Along the years, scientific clinical data have been collected concerning the possible saphenous flow restoration without any ablation and according with the CHIVA strategy. Moreover, in 2013 a Cochrane review highlighted the smaller recurrence risk following a CHIVA strategy rather than a saphenous stripping. Nevertheless, the saphenous sparing strategy surely remains a not-so-worldwide-spread and accepted therapeutic option, also because considered not so immediate and easy to perform. Aim of this paper is to provide an easily accessible guide to an everyday use of a saphenous sparing strategy for chronic venous disease, highlighting how even apparently too complicated reflux patterns classifications can be fastly and successfully managed and exploited for a hemodynamic correction.

38) P. ZAMBONI S.Gianesini: Surgical Technique for Deep Venous Reflux Suppression in Femoral Vein Duplication

(CHIVA in the deep system)

EJVES Short Reports Volume 30, 2016, Pages 10-12

Background

Deep venous surgery is a challenging field with limited indications. Femoral vein duplication (FVD) is a frequent anatomical variant (55% prevalence). The aim was to describe a simple technique for managing deep venous reflux in FVD, when just one of the two segments exhibits deep venous reflux.

Methods

The technique consists of closing the refluxing femoral branch with a titanium clip. In this way abolition of reflux along the duplicated vessel is achieved, together with the restoration of femoral vein drainage.

Results

The technique is feasible and associated with improvement in limb haemodynamics.

Pagine: 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 29 30