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ePaper created 2014-09-15, 12:31:02 | version 1.32.01
Phlebology Originally phlebology was not an important part of daily dermatologic care at the Erasmus MC. In 2001, the attention for this subdiscipline increased considerably; additional diagnostic and thera- peutic methods were implemented rapidly. Complex problems due to altered venous hemodynamics, such as post-thrombotic syndrome, pelvic vein insufficiency and congenital vascular malformations became areas of great interest. A start was made with duplex ultrasound examination and patients were treated with ultrasound-guided foam sclerotherapy and endovenous thermal ablation from 2002 onwards.[1] The number of available treatment modalities increased rapidly: endovenous laser ablation, segmental radiofrequency ablation, and later on, around 2009, endovenous steam ablation, the latter being a novel method, were introduced. Currently the Rotterdam department is one of the few places where the latter treatment is offered.[2, 4-6] Research on compression therapy showed that stiffness plays a determining role in choosing compression stockings. A new method for calculating the dynamic stiffness index of medical elastic compression stockings was introduced.[3] The last decade, a multidisciplinary approach has become increasingly important for the treatment of patients with complex phlebologic problems. Marianne Ghislena Renée De Maeseneer In view of these developments, Marianne Ghislena Renée De Maeseneer (1955), vascular surgeon with a special interest in phlebology, joined the department at the end of 2010. She further developed diagnostic strategies for patients with complicated post thrombotic obstruction, mainly by means of advanced duplex ultrasound of the deep venous system including the abdominopelvic veins.[7] In close collaboration with the departments of interventional radiology and vascular surgery, chronic recanalization and venous stenting was performed in selected patients. Recently the results were published of a survey performed in Belgium, the Netherlands and Luxembourg on chronic venous insufficiency in patients with atresia of the inferior caval vein.[8] On-going research in phlebology focussed on the subject of treatment and quality of life of patients with varicose vein and on ulcus cruris and venous pressure measurements.[9,10] References 1. Kockaert MA, Roos KP de, Neumann HA. [Echo-guided compression sclerotherapy using foam: an improvement in the treatment of varicose veins] Ned Tijdschr Geneesk 2006; 150: 1758-63. 2. Bos RR van den, Milleret R, Neumann M, et al. Proof-of-principle study of steam ablation as novel thermal therapy for saphenous varicose veins. J Vasc Surg 2010; 53: 181-6. 3. Stolk R, Wegen van der-Franken CP, Neumann HA. A method for measuring the dynamic behavior of medical compression hosiery during walking. Dermatol Surg 2004; 30: 729-36. 134 BWEADVSMGFINCORR:Opmaak 1 21-07-2014 17:40 Pagina 134