{"title":"Medicine: it’s time to change","authors":"A. Cavezzi","doi":"10.24019/jtavr.160","DOIUrl":"https://doi.org/10.24019/jtavr.160","url":null,"abstract":"","PeriodicalId":17406,"journal":{"name":"Journal of Theoretical and Applied Vascular Research","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"86505941","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
While Saphenous stripping became the gold standard technique for varicose veins treatment in the second part of last century, soon, leaving the Saphenous stem in place for surgical simplification and, successively, for arterial bypass use became a subject of research, showing uncertain responses. Ultrasound facilities allowed better hemodynamic knowledge; a new hemodynamic approach (CHIVA) appeared that limited venous ablation and redirected the blood to the deep system normalizing the pressures, allowing Great Saphenous Vein preservation. Even new technologic evolutions (thermal, chemical), created for venous ablation, could be converged toward this conservatory attitude simply changing the mental scheme.
{"title":"Saphenous sparing evolution","authors":"S. Ricci","doi":"10.24019/jtavr.146","DOIUrl":"https://doi.org/10.24019/jtavr.146","url":null,"abstract":"While Saphenous stripping became the gold standard technique for varicose veins treatment in the second part of last century, soon, leaving the Saphenous stem in place for surgical simplification and, successively, for arterial bypass use became a subject of research, showing uncertain responses. Ultrasound facilities allowed better hemodynamic knowledge; a new hemodynamic approach (CHIVA) appeared that limited venous ablation and redirected the blood to the deep system normalizing the pressures, allowing Great Saphenous Vein preservation. Even new technologic evolutions (thermal, chemical), created for venous ablation, could be converged toward this conservatory attitude simply changing the mental scheme.","PeriodicalId":17406,"journal":{"name":"Journal of Theoretical and Applied Vascular Research","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"82869798","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"CHIVA Course in Croatia","authors":"Frano Simic","doi":"10.24019/jtavr.163","DOIUrl":"https://doi.org/10.24019/jtavr.163","url":null,"abstract":"","PeriodicalId":17406,"journal":{"name":"Journal of Theoretical and Applied Vascular Research","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"72684807","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
N. Montelione, F. Stilo, V. Catanese, F. Codispoti, F. Spinelli
{"title":"Infrainguinal bypass using varicose veins with external scaffolding","authors":"N. Montelione, F. Stilo, V. Catanese, F. Codispoti, F. Spinelli","doi":"10.24019/jtavr.171","DOIUrl":"https://doi.org/10.24019/jtavr.171","url":null,"abstract":"","PeriodicalId":17406,"journal":{"name":"Journal of Theoretical and Applied Vascular Research","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"84576926","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
M. Cappelli, R. Molino Lova, M. Pinelli, C. Franceschi
This short review analyzes first the hemodynamic changes that follow destructive procedures, such as stripping or endovascular techniques, and conservative procedures, such as the CHIVA Cure. Then, the effects of the hemodynamic changes resulting from conservative and destructive procedures are compared with respect to the course over time of the varicose disease, mainly focusing on the occurrence of recurrences and their different hemodynamic characteristics. The results show that both conservative and destructive procedures significantly improve the plethysmographic reflux parameters till their normalization. However, destructive procedures reduce the compliance of the lower limb, which expresses an impaired drainage of the superficial tissue, as documented by the typical occurrence of recurrent varicose veins without a detectable trans-compartmental reflux point that are never found after conservative procedures. On the contrary, conservative procedures, when appropriately performed based upon the type of the venous shunt, preserve the drainage of the superficial tissues making the incompetent venous system more hemodynamically stable, which results in a significantly less frequent occurrence of recurrences.
{"title":"Are saphenous sparing treatments beneficial to the hemodynamics of the venous system?","authors":"M. Cappelli, R. Molino Lova, M. Pinelli, C. Franceschi","doi":"10.24019/jtavr.149","DOIUrl":"https://doi.org/10.24019/jtavr.149","url":null,"abstract":"This short review analyzes first the hemodynamic changes that follow destructive procedures, such as stripping or endovascular techniques, and conservative procedures, such as the CHIVA Cure. Then, the effects of the hemodynamic changes resulting from conservative and destructive procedures are compared with respect to the course over time of the varicose disease, mainly focusing on the occurrence of recurrences and their different hemodynamic characteristics. The results show that both conservative and destructive procedures significantly improve the plethysmographic reflux parameters till their normalization. However, destructive procedures reduce the compliance of the lower limb, which expresses an impaired drainage of the superficial tissue, as documented by the typical occurrence of recurrent varicose veins without a detectable trans-compartmental reflux point that are never found after conservative procedures. On the contrary, conservative procedures, when appropriately performed based upon the type of the venous shunt, preserve the drainage of the superficial tissues making the incompetent venous system more hemodynamically stable, which results in a significantly less frequent occurrence of recurrences.","PeriodicalId":17406,"journal":{"name":"Journal of Theoretical and Applied Vascular Research","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"88214017","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Prof. Bartolo, significant figure of Italian Angiology during the last decades of the XX century and founder of a Roman School of Angiology, was always sceptic about the surgical treatment of varicose veins. The modalities of stripping and its results were not a satisfactory surgical solution of the disease, from a clinical, aesthetic, social and finally economic point of view. Prof. Bartolo preferred conservative treatment in most cases, suggesting to give more space to minimally invasive treatments such as CHIVA, phlebectomy, sclerotherapy with the aim of achieving saphenous sparing and thus paving the way to the cultural foundation of modern phlebology. The current paper contains the translation and reprint of an Editorial of Prof. Bartolo about saphenous sparing treatments.
{"title":"The painting of Mauro Bartolo: ‘Pietas for the saphenous veins’, too many saphenous ablations in the days of academic stripping","authors":"Giuseppe Calandra","doi":"10.24019/jtavr.152","DOIUrl":"https://doi.org/10.24019/jtavr.152","url":null,"abstract":"Prof. Bartolo, significant figure of Italian Angiology during the last decades of the XX century and founder of a Roman School of Angiology, was always sceptic about the surgical treatment of varicose veins. The modalities of stripping and its results were not a satisfactory surgical solution of the disease, from a clinical, aesthetic, social and finally economic point of view. Prof. Bartolo preferred conservative treatment in most cases, suggesting to give more space to minimally invasive treatments such as CHIVA, phlebectomy, sclerotherapy with the aim of achieving saphenous sparing and thus paving the way to the cultural foundation of modern phlebology. The current paper contains the translation and reprint of an Editorial of Prof. Bartolo about saphenous sparing treatments.","PeriodicalId":17406,"journal":{"name":"Journal of Theoretical and Applied Vascular Research","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"91044229","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Saphenous sparing treatments: The ASVAL Method","authors":"P. Pittaluga","doi":"10.24019/jtavr.173","DOIUrl":"https://doi.org/10.24019/jtavr.173","url":null,"abstract":"","PeriodicalId":17406,"journal":{"name":"Journal of Theoretical and Applied Vascular Research","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"88961626","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Saphenous sparing editorial experience: present theories, reality, perspectives, to be continued","authors":"S. Ricci","doi":"10.24019/jtavr.168","DOIUrl":"https://doi.org/10.24019/jtavr.168","url":null,"abstract":"","PeriodicalId":17406,"journal":{"name":"Journal of Theoretical and Applied Vascular Research","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"80545598","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Population control and wild boars hunting","authors":"F. Passariello","doi":"10.24019/jtavr.169","DOIUrl":"https://doi.org/10.24019/jtavr.169","url":null,"abstract":"","PeriodicalId":17406,"journal":{"name":"Journal of Theoretical and Applied Vascular Research","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"78949553","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Venous valvuloplasty (VV) has been proposed for over 50 years to obtain functional reconstruction in patients with chronic venous insufficiency. The various techniques used have given long-term positive results in about 80% of the cases treated, which is moderately better than ablative techniques for the same pathologies. VV seems to be advisable in cases of poor compliance of the deep venous system following ablation of the great saphenous vein. Furthermore, it allows the saving of the saphenous conduit, which represents a precious advantage in case of need for arterial replacement surgery. So far it did not get widespread. Reasons for this include: rather strict eligibility criteria, which reduce the number of possible beneficiaries; the greater complexity of the procedure, both diagnostic and operative, compared to the endovascular ablative techniques proposed in recent decades; the scarce availability of adequate medical devices. Current research seems oriented towards the development of prosthetic neo-valves, made of biomaterials engineered with innovative techniques, which can be positioned by catheter in the deep venous system.
{"title":"An Overview on Venous Valvuloplasty and Saphenous Sparing","authors":"S. Camilli, Daniele Camilli","doi":"10.24019/jtavr.153","DOIUrl":"https://doi.org/10.24019/jtavr.153","url":null,"abstract":"Venous valvuloplasty (VV) has been proposed for over 50 years to obtain functional reconstruction in patients with chronic venous insufficiency. The various techniques used have given long-term positive results in about 80% of the cases treated, which is moderately better than ablative techniques for the same pathologies. VV seems to be advisable in cases of poor compliance of the deep venous system following ablation of the great saphenous vein. Furthermore, it allows the saving of the saphenous conduit, which represents a precious advantage in case of need for arterial replacement surgery. So far it did not get widespread. Reasons for this include: rather strict eligibility criteria, which reduce the number of possible beneficiaries; the greater complexity of the procedure, both diagnostic and operative, compared to the endovascular ablative techniques proposed in recent decades; the scarce availability of adequate medical devices. Current research seems oriented towards the development of prosthetic neo-valves, made of biomaterials engineered with innovative techniques, which can be positioned by catheter in the deep venous system.","PeriodicalId":17406,"journal":{"name":"Journal of Theoretical and Applied Vascular Research","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"78074824","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
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