Future of phlebology
•
3 likes•1,106 views
Presentation depicts current achievments in phlebology and future insights regading new technologies, new problems and opportunities
More Related Content
What's hot
What's hot (20)
Similar to Future of phlebology
Similar to Future of phlebology (20)
More from Michał Molski
More from Michał Molski (16)
Recently uploaded
Recently uploaded (20)
Future of phlebology
- 1. Surgical insight into future of phlebology Michał Molski
- 2. Deep venous system - Thrombosis • New technologies allow to perform procedures in deep venous system • Treatment of deep vein thrombosis • Treatment of postthrombotic syndrome • Treatment of deep system insuficiency
- 3. Deep venous system - Thrombosis • Change in imaging standard • Compression US in not enough • Complete venous roadmap • full duplex • MRV / CTV
- 4. Deep venous system – CT venography Assesment of postthrombotic lesions in ilio-femoral veins
- 5. Deep venous system - Thrombosis • A standarized DVT classification required • Documentation of pathology • Decision based on classification • Enables research • Lower Extremity Thrombosis • LET 1 – calf veins • LET 2 – POPV, SFV, DFV • LET 3 – ilio-femoral • LET 4 - caval
- 6. Deep venous system - Thrombosis • A standarized DVT classification required • Documentation of pathology • Decision based on classification • Enables research • Lower Venous Extremity SCORE • Each segment • Post thrombotic lesions • Residual stenosis • 0% • 10-50% • 50-90% • 100% • Collaterals • External compression
- 7. Deep venous system - Thrombosis • Current DVT treatment • Thrombolysis • Systemic • CDT • Mechanical • Pharmaco-mechanical • FUTURE • No thrombolitics • <1 hour • Outpatient • Lower cost • Lower complications • Patients with malignacies • Postoperative patients
- 8. Deep venous system - Thrombosis • Local thrombolytic devices • Trellis II • Low profile devices • Lazarus – 4F • Angiodynamics 14F device • Angiovac
- 9. Deep venous system - Obstruction Current Stent problems • Radial force • Kinking • Tappering • Stent rigifity • fractures • bamboo effect FUTURE • New better stents
- 10. Deep venous system - Obstruction • Endophlebectomy of CFV • Improves inflow • Patch? • AV fistula FUTURE • Percutaneous? • Endoscopic?
- 11. Deep venous system - Insuficciency Reflux in • Internal iliac vein • gonadal veins • vulval veins Clinical presentation • Pelvic congestion • Pubic varicosieties • Reccurent leg varicosities • Hemorhoids? Treatment options • Coils • sclerotherapy
- 12. Superficial & perforating system treatment • Classical surgical approach • Endovenous • Thermoablation • Chemical ablation • Thermo-chemical ablation • Mechano-chemical ablation • Hybrid procedures
- 14. Changes in phlebology Optimal medical care will be provided in specialised venous centers • High volume of patients • Expertise in simple and difficult cases • Complex diagnosis • Ultrasound • MR • CT • Complex treatment • Endovenous superficial procedures • Endovenous deep system procedures • Surgical • Esthetic • Sclerotherapy • Lasers
- 15. Complications of „minimally ivasive procedure” performed in famous clinic but went wrong – lack of expertise Scars & Bilateral severe parestesia
- 16. Changes in phlebology - Certification • Patients require to be treated by well trained physician • Many medical specialties interested in phlebology Surgeons, angiologists, dermatologists, esthetic medicine, radiologists, cardiologists • Standards required • Education • Training • CME • Exams • National certification • Polskie Towarzystwo Flebologiczne • International certification • European College of Phlebology • …
- 17. XX century - Golden age of surgeons XXI century – Dusk of surgeons? 1989 2008 2018
- 18. Thank you