Acta Phlebologica

Chronic venous disease (CVD) is a disorder of the lower limbs that affects a significant proportion of people worldwide. Signs of extensive CVD primarily include varicose veins, while in the advanced stages, irreversible dermal lesions such as dermatitis with lipodermatosclerosis and leg ulceration may occur. Phlebosclerosis refers to a fibrous degeneration affecting the vein wall, primarily the intima, with or without the presence of calcification. We present here the case of a 71-year-old patient diagnosed with advanced CVD, which presented varicose veins, hyperpigmentation with thickening of the skin and severe venous ulceration of the right leg. Two years prior, he underwent skin graft surgery for chronic venous ulcer. Ultrasonography of the great saphenous vein (GSV) revealed venous reflux at the saphenofemoral junction (SFJ) and an aneurysmal dilatation of the vein with a shiny mass located inside. Ablation of GSV was performed sequentially through the cryostripping procedure, and phlebosclerosis with calcification was identified. Postoperative recovery was rapid, and the intervention resulted in ulcer resolution within two weeks and no recurrence in the following year. A literature review of this association is also presented.

Sonia RAȚIU

Mihaela I. MARIȘ

Adrian STURZA

Sorin OLARIU

Danina M. MUNTEAN

Tiberiu BRATU

Phlebosclerosis with calcification in a patient with advanced venous ulcer: case presentation and literature review

静脉溃疡患者中的钙化性静脉硬化：病例报告与文献综述

Satyendra K. TIWARY

Ankush SHARMA

Khushbu PRIYA

Geeta RAI

Vivek K. KATIYAR

Puneet KUMAR

Ajay K. KHANNA

Gene expression study in venous ulcer

静脉溃疡基因表达研究

BACKGROUND: One of the most contentious issues within the field of phlebology is determining the best approach for correcting varicose tributaries following truncal ablation. Which strategy yields the highest effectiveness remains a subject of debate. Currently, there is a lack of substantial data regarding the selection of treatment strategies based on the diameter of varicose tributaries. Hence, the comparison between staged and one step treatment for varicose veins is a pertinent concern in contemporary phlebology. Conducting research in this area will enable the identification of the benefits and potential drawbacks associated with each proposed tactic.METHODS: The study involved a prospective analysis of 295 patients with varicose veins who received outpatient treatment as part of a combined therapy approach.RESULTS: Performing simultaneous endovenous laser ablation (EVLA) of saphenous trunks and ligation (gentle phlebectomy) of visibly large-diameter tributaries (6 mm or more), followed by staged sclerotherapy after a month, offers substantial potential advantages.CONCLUSIONS: Employing step-by-step treatment for varicose veins helps to reduce the level of traumatic intervention and discomfort experienced by the patient, all the while achieving satisfactory treatment outcomes without compromising the individual's quality of life.

Larisa CHERNUKHA

Olexandr VOLOSHYN

Olexandr SUZDALENKO

Viktor GUBKA

Serhii MACHUSKUI

Viktor PAVLYCHENKO

One-step or step-by-step approaches to varicose veins treatment: timing, method, rationale

一步法还是分步法治疗静脉曲张：时机、方法与原理

BACKGROUND: The aim of the study was to examine the anatomical features of the dural sinuses using magnetic resonance venography and viscoelastic properties of erythrocyte membranes in adolescents with connective tissue dysplasia using atomic force microscopy.METHODS: A total of 156 adolescents were examined. The main group (MG) consisted of 82 adolescents with signs of connective tissue dysplasia (CTD). The comparison group included 74 adolescents without manifestations of CTD. Connective tissue dysplasia was evaluated using the scale offered by L.N. Abakumova (2006). Magnetic resonance angiography was performed with the application of the Siemens Magnetom Symphony system equipped with a superconducting magnetic system with a field strength of 1.5 Tesla. Dry preparations of erythrocytes were prepared to study the state of the cytoplasmic membrane of erythrocytes. The preparation was subjected to scanning, which was carried out using a SOLVER P47-Pro atomic force microscope.RESULTS: Anatomical variations in the structure of the dural sinuses were identified in most adolescents of the MG. At the same time, hypoplasia of the sinuses in patients of the MG was diagnosed more often than asymmetry of these structures. In the CG, the number of anatomical variations in the structure of the dural sinuses also prevailed over the symmetrical structure, but asymmetry of the sinuses was diagnosed more often. A comparative analysis of Young's modulus values in two groups of patients showed a statistically significant superiority of this indicator in the MG. Correlation analysis of the severity of CTD and Young's modulus values revealed a moderate, direct relationship.CONCLUSIONS: In view of the foregoing, it is possible to assume that the structural features of cerebral vessels and the elastic properties of erythrocyte membranes present in CTD, which are inherent in the process of embryogenesis, worsen the functional and adaptive capabilities of intracranial vessels, which contributes to the emergence and progression of cerebral venous disorders with their subsequent clinical manifestation.

Victor V. MASHIN

Liudmila A. BELOVA

Pier Luigi ANTIGNANI

Natalia V. BELOVA

Artem N. PROSHIN

Angelina A. KISELEVA

Dinara T. BARGAEVA

Specific features of dural sinuses and structural-functional properties of erythrocyte membranes in adolescents with connective tissue dysplasia

青少年结缔组织发育异常中硬脑膜窦的特异性特征及红细胞膜的结构-功能特性

BACKGROUND: In specific scenarios such as ampullated dilation of the saphenous vein at the "crosse," absence/incontinence of the supra-saphenous femoral valve, and anatomical anomalies at the crosse or a high outlet of the anterolateral saphenous vein to the "crosse," thermal ablation is not the preferred approach. Instead, the Excluded Saphenous Vein Technique (ESVT) is utilized, involving selective crossectomy rather than stripping. This study aims to compare the effectiveness of ESVT with stripping, both interventions involving selective crossectomy.METHODS: A preoperative clinical and instrumental screening phase categorized patients into two groups: the ESVT group (105/200 patients) underwent ESVT and selective crossectomy, while the Stripping group (95/200 patients) underwent stripping and selective crossectomy. The primary outcome was the recurrence rate, defined as total recanalization of the great saphenous vein and/or onset of new saphenous vein and/or new varicose veins.RESULTS: Follow-up occurred at 10-day, 30-day, 1-, 6-, and 36-month intervals using Duplex scan. Recurrence rates were 2.8% and 6.31% for ESVT and Stripping, respectively, with no significant difference between the two groups (ESVT vs. stripping: OR 0.43, 95% CI [0.06; 2.12], P=0.313).CONCLUSIONS: ESVT offers several advantages over stripping in the aforementioned cases, including performance under local anesthesia, absence of thigh bruises, earlier patient discharge, and cost-effectiveness. In Italy, approximately 70% of venous treatments involve stripping. However, based on our findings, ESVT stands as a viable alternative to stripping, exhibiting equal effectiveness and safety along with notable advantages.

Maurizio PAGANO

Daniele BISSACCO

Andrea LUPASCU

Alex AVERSANO

Umberto AVERSANO

Antonio PELUSO

Renato CASANA

Giorgio ESPOSITO

Paolo TONDI

Comparing excluded saphenous vein technique with great saphenous vein stripping after 3 years

比较排除隐静脉技术与大隐静脉剥脱术后3年的效果

Abbreviation
Journal Impact	0.24
Quartiles(Global)	PERIPHERAL VASCULAR DISEASE(Q4)

ISSN	1593-232X, 1827-1766
h-index	10

Publication Information	Publisher: Edizioni Minerva Medica S.p.A.，Publishing cycle: ，Journal Type: journal，Open Access Journals: No
Basic data	Year of publication: 2013，Proportion of original research papers: 88.89%，Self Citation Rate:50.00%， Gold OA Rate: 2.00%

Acta Phlebologica

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Phlebosclerosis with calcification in a patient with advanced venous ulcer: case presentation and literature review

Gene expression study in venous ulcer

One-step or step-by-step approaches to varicose veins treatment: timing, method, rationale

Specific features of dural sinuses and structural-functional properties of erythrocyte membranes in adolescents with connective tissue dysplasia

Comparing excluded saphenous vein technique with great saphenous vein stripping after 3 years

Phlebosclerosis with calcification in a patient with advanced venous ulcer: case presentation and literature review

Gene expression study in venous ulcer

One-step or step-by-step approaches to varicose veins treatment: timing, method, rationale

Specific features of dural sinuses and structural-functional properties of erythrocyte membranes in adolescents with connective tissue dysplasia

Comparing excluded saphenous vein technique with great saphenous vein stripping after 3 years