Seminars in Vascular Surgery RSS feed: Current Issue. Each issue of Seminars in Vascular Surgery examines the latest thinking on a particular clinical problem and features new diagnostic and operative techniques. The journal allows practitioners to expand their capabilities and to keep pace with the most rapidly evolving areas of surgery. Seminars in Vascular Surgery is indexed/abstracted in: Science Citation Index Expanded (SciSearch®), Current Contents®/Clinical Medicine, and Journal Citation Reports/Science Edition. 2009 Topics , Volume 22 June Dealing with Long-Term Problems after Endovascular and Open Aortic Repair http://www.semvascsurg.com/?rss=yesElsevier Inc.en © 2010 Published by Elsevier Inc. All rights reserved. Seminars in Vascular Surgery0895-7967232June 2010 © 2010 Published by Elsevier Inc. All rights reserved. healthpermissions@elsevier.comhttp://www.semvascsurg.com/article/PIIS0895796710000256/abstract?rss=yesContents10.1053/S0895-7967(10)00025-6Seminars in Vascular Surgery 23, 2 (2010)2010-06-01Seminars in Vascular Surgery2010-06-01232S0895-7967(10)X0003-5iihttp://www.semvascsurg.com/article/PIIS0895796710000268/abstract?rss=yesForthcoming/Previous Issues10.1053/S0895-7967(10)00026-8Seminars in Vascular Surgery 23, 2 (2010)2010-06-01Seminars in Vascular Surgery2010-06-01232S0895-7967(10)X0003-5iiiihttp://www.semvascsurg.com/article/PIIS0895796710000025/abstract?rss=yesTHIS ISSUE OF Seminars in Vascular Surgery, “Modern Management of Superficial Venous Insufficiency: Out with the Old, In with the New,” leaves the reader with little doubt that the treatment of venous disease is the most exciting and rapidly evolving field within our specialty of vascular surgery.IntroductionCynthia K. Shortell, Ruth L. Bush10.1053/j.semvascsurg.2010.01.001Seminars in Vascular Surgery 23, 2 (2010)2010-06-01Seminars in Vascular Surgery2010-06-01232S0895-7967(10)X0003-56969http://www.semvascsurg.com/article/PIIS0895796710000037/abstract?rss=yesThere is a need for a standardized consistent language in vascular surgery that allows easy flow of information and comparison of results among clinicians. Beginning with current nomenclature, a common language serves as a framework for more detailed efforts. Understanding the outcomes assessment tools available provides the opportunity for universal outcomes reporting. Data collected at widespread points can then be fairly compared, and common goals of therapy can be determined. Common outcomes that have demonstrated verifiable trends and reproducibility should be subjected to the rigors of evidence-based questioning. The resultant standards of care and expectations of therapy are then confidently presented for everyday practice and ongoing research.The Importance of Uniform Venous Terminology in Reports on Varicose VeinsMichael A. Vasquez, Carolyn E. Munschauer10.1053/j.semvascsurg.2010.01.002Seminars in Vascular Surgery 23, 2 (2010)2010-06-01Seminars in Vascular Surgery2010-06-01232S0895-7967(10)X0003-57077http://www.semvascsurg.com/article/PIIS0895796710000049/abstract?rss=yesVaricose veins and associated venous insufficiency are among the most common vascular conditions requiring specialist evaluation and treatment. Over 80% of people studied in a population based evaluation were found to have visible evidence of venous disease. In this article, the epidemiology of venous disease will be reviewed with specific attention to the common symptom patterns displayed by patients with superficial venous disease. Based on physical examination, the clinician can determine the likely sites of venous insufficiency and efficiently direct use of various diagnostic modalities, such as duplex ultrasound. The importance of the CEAP clinical classification will be discussed as a guide to choosing therapy from the multitude of available options for patients with venous insufficiency.Evaluation of Varicose Veins: What do the Clinical Signs and Symptoms Reveal about the Underlying Disease and Need for Intervention?William A. Marston10.1053/j.semvascsurg.2010.01.003Seminars in Vascular Surgery 23, 2 (2010)2010-06-01Seminars in Vascular Surgery2010-06-01232S0895-7967(10)X0003-57884http://www.semvascsurg.com/article/PIIS0895796710000190/abstract?rss=yesRecent advances in the treatment of venous insufficiency have led to an increased utilization of venous ultrasonography by practitioners. Knowing the fundamentals of anatomy and physiology are essential to be successful. This article reviews the common uses of ultrasonagraphy for the examination of the lower extremity venous system.Importance of Ultrasound Evaluation in the Diagnosis of Venous Insufficiency: Guidelines and TechniquesDavid Gillespie, Carolyn Glass10.1053/j.semvascsurg.2010.02.001Seminars in Vascular Surgery 23, 2 (2010)2010-06-01Seminars in Vascular Surgery2010-06-01232S0895-7967(10)X0003-58589http://www.semvascsurg.com/article/PIIS0895796710000050/abstract?rss=yesSuperficial venous insufficiency of the lower extremities is a common affliction. There are several modalities available to the clinician to treat this problem. This article specifically examines the technique of radiofrequency ablation in the treatment of superficial venous insufficiency. The evolution of the catheters used in radiofrequency ablation is discussed in detail. The mechanism of action of the radiofrequency energy on the vein wall is explained. Several technical aspects of the technique, such as temperature set point and pull-back speed are described. The importance of tumescent anesthesia and its role in reducing complications are illustrated. Short- and long-term results of radiofrequency ablation are compared to results with both operative therapy or endovenous laser therapy, the results are similar if not better. Complications of radiofrequency ablation therapy are discussed, emphasizing the advent of tumescent anesthesia and the resultant drop in paresthesias. Outcome analysis of radiofrequency ablation is shown to have positive effects on both clinical-etiologic-anatomic-pathophysiologic class and venous clinical severity score. Finally other considerations, including billing and necessary supplies, are summarized. In summary, radiofrequency ablation is shown to be a safe and effective modality in the treatment of superficial venous insufficiency.Radiofrequency Ablation: Evolution of a TreatmentJoann Lohr, Aaron Kulwicki10.1053/j.semvascsurg.2010.01.004Seminars in Vascular Surgery 23, 2 (2010)2010-06-01Seminars in Vascular Surgery2010-06-01232S0895-7967(10)X0003-590100http://www.semvascsurg.com/article/PIIS0895796710000062/abstract?rss=yesVaricose veins of the lower extremity are commonly encountered by vascular surgeons. Historically, the standard treatment of varicose veins has been high ligation and stripping of the great saphenous vein. Endovenous ablation techniques have been adopted by many surgeons over the past few years. Techniques of endovenous laser surgery are reviewed, as are the common complications and expected outcomes.Laser Treatment of Varicose Veins: Order Out of ChaosJennifer L. Ash, Colleen J. Moore10.1053/j.semvascsurg.2010.01.005Seminars in Vascular Surgery 23, 2 (2010)2010-06-01Seminars in Vascular Surgery2010-06-01232S0895-7967(10)X0003-5101106http://www.semvascsurg.com/article/PIIS0895796710000074/abstract?rss=yesPhysicians have several options to treat varicose veins that remain after successful axial vein ablation. Foam sclerotherapy is effective for all sorts of veins, but may become less effective and have a higher risk of complications when treating large diameter veins. Endovenous laser and radiofrequency ablation can be used to treat nontortuous tributaries. Ambulatory phlebectomy is useful for visible and palpable veins.Management of Secondary VaricositiesEric Mowatt-Larssen10.1053/j.semvascsurg.2010.01.006Seminars in Vascular Surgery 23, 2 (2010)2010-06-01Seminars in Vascular Surgery2010-06-01232S0895-7967(10)X0003-5107112http://www.semvascsurg.com/article/PIIS0895796710000086/abstract?rss=yesFor nearly a century, surgeons have recognized that incompetent perforator veins (IPVs) likely play a role in the development of venous pathology. Although surgical management of IPVs has improved significantly since Linton first described his approach in 1938, little evidence exists that clearly defines the role of IPV interruption as a modern treatment for complicated venous insufficiency of the lower extremity. The purpose of this article is to review the literature in an attempt to clarify the role for IPV therapies as either adjunct or independent treatment for complicated venous insufficiency. Additionally, a summary of IPV diagnosis, patient selection, and current ablative therapies will hopefully serve as a guide for surgeons who manage venous disease.Diagnosis and Current Management of Incompetent Perforator VeinsJ. Leigh Eidson, Ruth L. Bush10.1053/j.semvascsurg.2010.01.007Seminars in Vascular Surgery 23, 2 (2010)2010-06-01Seminars in Vascular Surgery2010-06-01232S0895-7967(10)X0003-5113117http://www.semvascsurg.com/article/PIIS0895796710000098/abstract?rss=yesBased on a theoretical hemodynamic model, CHIVA (conservative hemodynamic cure for venous insufficiency) is an ultrasound-guided, minimally invasive surgical strategy performed under local anesthesia for the treatment of patients with varicose vein disease. After careful duplex mapping, the surgeon performs flush ligation procedures at the proximal origin of key points of reflux while meticulously maintaining superficial venous drainage to prevent varicosity recurrence. The saphenous veins are preserved. The strategy has been shown in studies to be safe and effective.CHIVAEric Mowatt-Larssen, Cynthia Shortell10.1053/j.semvascsurg.2010.01.008Seminars in Vascular Surgery 23, 2 (2010)2010-06-01Seminars in Vascular Surgery2010-06-01232S0895-7967(10)X0003-5118122http://www.semvascsurg.com/article/PIIS0895796710000104/abstract?rss=yesFoam sclerotherapy is not a defined procedure nor is the product uniform or licensed for use but it is now accepted practice in most territories worldwide. Foam sclerotherapy has been used to treat a wide range of venous conditions from the closure of incompetent great saphenous trunk veins to telangiectasia and from venous malformations to hemorrhoids with good outcomes being reported. There is a rapidly expanding body of literature supporting its safety and efficacy as well as a few case histories of serious complications. This article will focus on the current role of foam sclerotherapy in the treatment of varicose veins.What is the Current Role of Foam Sclerotherapy in Treating Reflux and Varicosities?David D.I. Wright10.1053/j.semvascsurg.2010.01.009Seminars in Vascular Surgery 23, 2 (2010)2010-06-01Seminars in Vascular Surgery2010-06-01232S0895-7967(10)X0003-5123126