Sclerotherapy E-Book , livre ebook

Sclerotherapy
Treatment of Varicose and Telangiectatic Leg Veins
Fifth Edition

Mitchel P. Goldman, MD
Volunteer Clinical Professor of Dermatology and Medicine, University of California at San Diego, Medical Director, La Jolla Spa MD, La Jolla, CA, USA

Jean-Jérôme Guex, MD FACPh
Professor, University of Nice, Nice, France

Robert A. Weiss, MD
Maryland Laser, Skin and Vein Institute, LLC., Aspen Mill Professional Building, Hunt Valley, MD, USA
Saunders
Front Matter
FIFTH EDITION

Sclerotherapy
Treatment of Varicose AND Telangiectatic Leg Veins
EDITORS:
Mitchel P. Goldman MD,
Volunteer Clinical Professor of Dermatology and Medicine, University of California at San Diego, Medical Director, La Jolla Spa MD, La Jolla, CA, USA
Jean-Jérôme Guex MD FACPh,
Professor, University of Nice, Nice, France
Robert A. Weiss MD,
Maryland Laser, Skin and Vein Institute, LLC., Aspen Mill Professional Building, Hunt Valley, MD, USA
CONTRIBUTORS
Albert-Adrien Ramelet MD,
Consultant and Lecturer, University of Bern, Lausanne, Switzerland
Stefano Ricci MD,
Phlebologist, Private Practice, Corso Trtieste, Rome, Italy
Hugo Partsch,
Emeritus Professor of Dermatology, Medical University of Vienna, Vienna, Austria
Michel Perrin MD,
Vascular Surgery, Department Unité de Pathologie Vasculaire Jean Kunlin, Clinique du Grand Large
Chassieu, France
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Copyright

Saunders an imprint of Elsevier Inc.
© 2011, Elsevier Inc. All rights reserved.
First edition 1991
Second edition 1995
Third edition 2001
Fourth edition 2007
No part of this publication may be reproduced or transmitted in any form or by any means, electronic or mechanical, including photocopying, recording, or any information storage and retrieval system, without permission in writing from the publisher. Details on how to seek permission, further information about the Publisher’s permissions policies and our arrangements with organizations such as the Copyright Clearance Center and the Copyright Licensing Agency, can be found at our website: www.elsevier.com/permissions .
This book and the individual contributions contained in it are protected under copyright by the Publisher (other than as may be noted herein).


Notices
Knowledge and best practice in this field are constantly changing. As new research and experience broaden our understanding, changes in research methods, professional practices, or medical treatment may become necessary. Practitioners and researchers must always rely on their own experience and knowledge in evaluating and using any information, methods, compounds, or experiments described herein. In using such information or methods they should be mindful of their own safety and the safety of others, including parties for whom they have a professional responsibility.
With respect to any drug or pharmaceutical products identified, readers are advised to check the most current information provided (i) on procedures featured or (ii) by the manufacturer of each product to be administered, to verify the recommended dose or formula, the method and duration of administration, and contraindications. It is the responsibility of practitioners, relying on their own experience and knowledge of their patients, to make diagnoses, to determine dosages and the best treatment for each individual patient, and to take all appropriate safety precautions.
To the fullest extent of the law, neither the Publisher nor the authors, contributors, or editors, assume any liability for any injury and/or damage to persons or property as a matter of products liability, negligence or otherwise, or from any use or operation of any methods, products, instructions, or ideas contained in the material herein.
British Library Cataloguing in Publication Data
A catalogue record for this book is available from the British Library
Saunders
Sclerotherapy: treatment of varicose and telangiectatic
leg veins. – 5th ed.
1.  Sclerotherapy. 2.  Varicose veins–Treatment.
I.  Goldman, Mitchel P.
616.1′43′06-dc22
ISBN-13: 9780323073677
Library of Congress Cataloging in Publication Data
A catalog record for this book is available from the Library of Congress



Printed in China
Last digit is the print number: 9  8  7  6  5  4  3  2  1
Preface
The first edition of this text was written almost 25 years ago at the beginning of my medical career. Although it was thought of as an authoritative text, it merely represented a review of the world’s literature on sclerotherapy and actually served to teach me the basics of phlebology. The second edition, written five years later, expanded on the theme of an encyclopedic review of the literature and included more practical information now gained through my early experience in phlebology. The third edition, written five years later, brought my co-author and teacher John Bergan to add his depth of knowledge and expertise. The third edition again continued in the spirit of an encyclopedic dissertation with more practical information and case reports. The fourth edition brought another co-editor, J-J. Guex to the text to add both a European perspective to the text as well as include more international knowlege and expertise. In addition Professor Hugo Partsch, the world’s leading authority on compression therapy re-wrote the Compression chapter and Albert-Adrien Ramelet, MD included the first chapter on Veno-Active drugs. For the fifth edition, we have added Robert Weiss, MD as a co-editor to replace the retirement of our Dr. John Bergan. In addition to adding his expertise to each chapter, Bob is responsible for updating the accompanying DVD filled with educational and practical videos to aid physicians into applying the knowledge of this text in a practical maner to their patient practice.
Phlebology and the treatment of varicose and telangiectatic leg veins continues to evolve significantly with the addition of endovenous laser and radiofrequency techniques for treating the great and small saphenous veins as well as perforator and tributary veins. In addition, the resurgence of using foamed sclerosing agents has expanded our treatment abilities while minimizing adverse effects.
The world has continued to grow smaller, with the International Union of Phlebology serving to bring physicians from all nations together every two years to share their experiences. This has led to an increasing body of knowledge that deserves to be organized in one source. It should therefore come as no surprise that this fifth edition contains approx 416 new references, a totally revised anatomy chapter co-authored with Stefano Ricci, MD a world class historian, anatomist and phlebologist, and the surgical chapter re-written by Michel Perrin, MD, Vice-President of the IUP, a senior internationally respected Vascular Surgeon and Phlebologist. The addition of these international leaders and outstanding teachers and clinicians from France and Italy further broaden the breath of this text.
The success of the combined efforts of the new co-editor and two additional chapter editors is represented by the approx 84 new illustrations and 10 new tables, all of which should increase the practicality of the fifth edition while maintaining its encyclopedic nature.
The enhancement of patient care evidenced through an increase in successful treatment while minimizing adverse events is the reason for our joint efforts. I thank the world phlebological community for sharing the combined expertise of thousands of physicians in such a selfless manner under the encouragement of the International Union and each country’s phlebological society.

Mitchel P. Goldman, Founder and Editor-in-Chief
2010
Dedication
To our friend, teacher and colleague, John J. Bergan. He took the field of phlebology in the United States from completely unrecognized to what he called ‘Cinderella’ coming out to the ball. And phlebology found more than the glass slipper, it became the ‘princess’ of subspecialties for doctors excited about advancing their knowledge and treatment of varicose and spider veins.
Dr. Bergan’s approach was to include multi-specialties and devote himself to teaching the principles of vein surgery to all who were interested. His keen logic and practical approach allowed the expansion of phlebology to include much more than his vascular surgery perspective. He clearly excelled at making vascular surgeons aware of the importance of venous disease. But he went beyond and was willing to explore and accept advances in sclerotherapy, ambulatory phlebectomy and endovenous ablation incorporating advances from all fields. His spirit of cooperation and dedication kept the magic alive through his eloquent and motivating teaching combined with his practical approach to patient care. Physicians from all specialties throughout the world have benefited from