Manual of Venous and Lymphatic Diseases

Australasian College of Phlebology, Ken Myers, Paul Hannah, Ken Myers, Paul Hannah

• Publisher: CRC Press
• Year: 2017
• eBook ISBN:
  9781351712903
• Topic: Medicina
• Subtopic: Cardiología

The Manual of Venous and Lymphatic Diseases constitutes a concise but comprehensive and contemporary description of the nature and management of venous and lymphatic diseases. This innovative book instructs the post-graduate trainee in phlebology and is also valuable to undergraduate students wishing to gain a broader knowledge than is available in general surgical texts. Addtionally, it is a useful reference for practising phelebologists, vascular surgeons and imaging specialists. The text covers basic principles, diagnosis and treatment of chronic venous disease, venous thrombo-embolism, lymphoedema and vascular malformations.

Contents

Preface

Foreword

1 Embryology of veins and lymphatics

2 Anatomy of veins and lymphatics

3 Physiology of veins and lymphatics

4 Physics of sound and light

5 Pharmacology for venous and lymphatic diseases

6 Clinical presentations for chronic venous diseases

7 Pathogenesis of varicose disease

8 Selecting treatment for superficial venous disease

9 Preparing for treatment of superficial venous disease

10 Investigations for chronic venous diseases

11 Conservative treatment

12 Direct-vision and ultrasound-guided sclerotherapy

13 Endovenous ablation and cyanoacrylate closure

14 Surgery for lower limb varicose disease

15 Chronic deep venous disease

16 Venous compression syndromes

17 Other venous disorders

18 Lymphoedema – pathology and clinical features

19 Lymphoedema – investigation and treatment

20 Haemostasis and fibrinolysis

21 Antiplatelet, And Thrombolytic Agents

22 Venous thrombo- embolism: pathology and clinical features

23 Venous thrombo- embolism: diagnosis

24 Venous thrombo-embolism: prevention

25 Venous thrombo- embolism – treatment

26 Vascular tumours and congenital vascular malformations

27 Measuring Management outcomes

Index

Preface

This book has grown out of a need for a comprehensive syllabus directed to trainees in phlebology, but from there has hopefully developed into a reference book for all practitioners. It started as an effort to bridge a gap between traditional phlebology textbooks and a study guide for prospective examination candidates. It now attempts to provide a summary of venous and lymphatic diseases that will be of value to a broader audience of undergraduates and graduates who have a general interest in the subject or are specialists in diagnostic or interventional aspects of these conditions.

The text is a product of input from members of the Australasian College of Phlebology based on their expertise and experience rather than a range of specific scientific works. The chapters were subsequently submitted to other local and international colleagues to help provide a broader perspective. We recognise the need for evidence to support these views by referral to the recent scientific literature and international consensus documents, and hope that this has helped reduce personal bias. There are likely to be regional attitudes for management that may not be common to all countries, but we hope that allowance can be made for these variations.

There is now a great depth of knowledge about venous and lymphatic diseases and no single group is likely to be experienced in all aspects. With this in mind, major international organizations have commissioned groups of interested experts to produce consensus documents and conduct working parties to study specific aspects of the disease in detail. Our project has leaned heavily on these documents as a source of information, and our summaries of the extensive material are acknowledged in the individual chapters. We thank these working groups for providing the ground work for us to incorporate into our work a synthesis of their deliberations. Any errors or generalizations in interpreting these documents are entirely our responsibility.

References to these consensus documents and to major reviews are listed with internet links to all, generally directing the reader to the full text. Other selected references to contemporary or historical reports have been included if considered to be of special importance. No attempt has been made to provide an extensive reference base for all aspects of the many conditions, as these are listed within the references that we have provided

The presentation is deliberately didactic but hopefully balanced and comprehensive. Included are many boxed summaries of highlights, tips and warnings. Many of the agents used for treatment carry their Australasian names and will need to be cross-referenced by international readers. Illustrations have been kept simple and may need to be supplemented by reference to more specialized texts for further study. Several procedures in common use have been described in detail, however, it is important to note that the descriptors relating to them are not sufficient for performing any of the indicated processes. Proper training under supervision must be sought.

It is hoped that this manual will help when you next encounter the problem patient or are faced with making a difficult management decision

Ken Myers and Paul Hannah

Foreword

Dear Readers,

I take this opportunity as President of the International Union of Phlebology (UIP) to introduce this Manual of Venous and Lymphatic Diseases on behalf of the Australasian College of Phlebology (ACP), one of the most important member societies in the UIP.

The leadership of the ACP, in conjunction with members of the Editorial Committee has organized, directed, and created this text which will come to be an indispensable tool for all those practicing in the field of venous and lymphatic medicine. This work of the ACP is welcomed and deeply appreciated by the UIP.

The UIP is currently developing several initiatives that will enhance education and research of venous and lymphatic disorders. One initiative may be a certificate of knowledge of phlebology. Also, it is expected there will soon be an independent funding entity available to the UIP that should be able to facilitate and accelerate education and research worldwide. Through such initiatives, it is anticipated that the level of understanding of venous and lymphatic disorders will improve the health of patients suffering from these disorders more uniformly across the globe.

It is a great honour to recognize the work involved in the production of this text, and my congratulations to the editors for their tremendous efforts to elevate knowledge in the field of venous and lymphatic medicine.

With great respect,

Nick Morrison, MD, FACS, FACPh, RPhS
President, International Union of Phlebology

1Embryology of veins and lymphatics

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The venous system

Knowing how veins and lymphatics develop provides a basis for understanding their anatomy and helps explain congenital vascular malformations and developmental abnormalities. ^{1, 2}

• The embryo has three systems of paired veins – vitelline veins taking nutrients from the yolk sac, umbilical veins carrying ox ygenated blood from the placenta and a systemic system of cardinal veins (Figure 1.1).
• The embryonic vascular system appears as cords of cells in the mesoderm by 15–16 days, and these differentiate into blood cells and vessels. Veins develop from an irregular capillary network within the first five to six weeks and the architecture is complete by eight weeks. Lymphatics bud off veins and appear at the end of week five, about two weeks later than blood vessels. Venous valves appear by 12 weeks as thickened ridges filled in with mesenchyme, which then widen and thin down to their final shape. ³

Figure 1.1 Lateral view of the embryo at eight weeks showing components of the foetal venous circulation - the cardinal, vitelline and umbilical veins.

Vitelline veins

• Vitelline veins take blood from the yolk sac to the embryo and are later modified to become the superior mesenteric and portal veins, liver sinusoids and hepatic veins, and the final segment becomes the supra-hepatic section of the inferior vena cava.
• The yolk sac provides a blood supply and a source of nutrients during early development, but the vitelline circulation ceases by the fourth week as the yolk sac atrophies to be incorporated into the primordial gut.

Umbilica...

Table of contents

• Cover
• Halftitle
• Title Page
• Copyright Page
• Table of Contents