Influence of reimbursement policies on phlebological surgical practice in Belgium between 2007 and 2017.

Background: To date, it is unclear how treatment of patients with chronic venous disease (CVD) is influenced by national reimbursement systems. In Belgium, catheters or fibers used for endovenous thermal ablation (EVTA) are reimbursed only once in a lifetime. The potential impact of the Belgian public health insurance reimbursement policy on surgical practice in phlebology needs to be investigated.

The effect of single phlebectomies of a large varicose tributary on great saphenous vein reflux.

Objective: Phlebectomy of varicose tributaries is usually considered an additional treatment after or during saphenous ablation. As phlebectomies alone affect the hemodynamics of the venous system, this treatment can be effective as primary intervention in selected patients. The objective of this study was to analyze hemodynamic, clinical, and patient-reported outcomes after phlebectomies in a prospective multicenter study to determine predictors for treatment success, that is, restoration of great saphenous vein (GSV) competence.

Comparing endovenous laser ablation, foam sclerotherapy, and conventional surgery for great saphenous varicose veins.

Background: Many case series have been published on treatments of varicose veins, but comparative randomized controlled trials remain sparse.

Objective: To compare the anatomic success rate, frequency of major complications, and quality-of-life improvement of endovenous laser ablation (EVLA), ultrasound-guided foam sclerotherapy (UGFS), and conventional surgery (CS), after 1-year follow-up.

Methods: A total of 240 consecutive patients with primary symptomatic great saphenous vein reflux were randomized to EVLA, UGFS, or CS, consisting of high ligation and short stripping.

Chronic venous insufficiency in patients with absence of the inferior vena cava.

Objective: Up until now, knowledge of absence of the inferior vena cava (AIVC) is limited to case reports and small case series, usually reported shortly after diagnosis. To characterize long-term evolution of outcomes of patients with AIVC, we performed a survey of current practice in Belgium, The Netherlands, and Luxembourg (Benelux).

Methods: Vascular surgeons and phlebologists in the Benelux area were asked to complete a questionnaire on medical history and treatment of each patient in follow-up at their practice with a diagnosis of AIVC.

A giant aneurysm of the popliteal vein.

Popliteal vein aneurysm is a rare diagnosis, associated with a 70 % risk of pulmonary embolism, sometimes even with fatal evolution. Surgery dramatically reduces the risk of pulmonary embolism. We report a case of a 66-year-old man with recurrent pulmonary embolism and a giant popliteal venous aneurysm (9.

Early and late complications of silicone patch saphenoplasty at the saphenofemoral junction.

Background: To reduce the incidence of postoperative recurrence after great saphenous vein (GSV) surgery, various barrier techniques have been introduced, aiming at containment of postoperative neovascularization at the saphenofemoral junction in the groin. Interposition of a prosthetic barrier (patch saphenoplasty) may be useful for this purpose; however, the incidence of postoperative complications after patch saphenoplasty is unknown. A prospective study examined the incidence of complications after patch saphenoplasty in primary and repeat varicose vein surgery.

Patient characteristics and physician-determined variables affecting saphenofemoral reflux recurrence after ligation and stripping of the great saphenous vein.

Objective: To identify patient and physician-controlled treatment variables that might predict the persistence or redevelopment of saphenofemoral junction (SFJ) reflux.

Methods: Thirteen European centers, with substantial lower extremity venous disease practices, examined their experience with SFJ ligation and GSV stripping for primary varicose veins in patients followed for > or =2 years, entering their data into a protocol-driven matrix that stipulated duplex Doppler imaging as an essential component of follow-up examinations and required a complete review of all peri-operative examinations, as well as all operative procedure and anesthesia notes. Matrix entries were centrally audited for consistency and credibility, and queried for correction or clarification before being accepted into the study database.

Silicone patch saphenoplasty to prevent repeat recurrence after surgery to treat recurrent saphenofemoral incompetence: long-term follow-up study.

Objective: Barrier techniques have been proposed to improve the results of repeat surgery to treat recurrent saphenofemoral junction incompetence. We hypothesized that interposition of a silicone implant would contain postoperative neovascularization and thus reduce the incidence of clinical recurrence at 5-year follow-up.

Methods: We compared the results of repeat interventions with use of silicone sheeting with a control group without artificial implants.