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COMPRESSION THERAPY BY STOCKINGS and EPI-FASCIAL VEINS

COMPRESSION THERAPY BY STOCKINGS and EPI-FASCIAL VEINS. RASTEL D. 1 , LUN B. 2 , ROHAN P-Y. 3 , BADEL P. 3 , AVRIL S. 3 1 Vascular Medecine, Grenoble ; 2 SIGVARIS, Saint-Just Saint-Rambert, 3 Ecole des Mines de St Etienne, France. SIGVARIS Symposium - European Venous Forum 2014.

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COMPRESSION THERAPY BY STOCKINGS and EPI-FASCIAL VEINS

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  1. COMPRESSION THERAPY BY STOCKINGS and EPI-FASCIAL VEINS RASTEL D. 1, LUN B. 2, ROHAN P-Y. 3, BADEL P. 3 , AVRIL S. 3 1 Vascular Medecine, Grenoble ; 2 SIGVARIS, Saint-Just Saint-Rambert, 3 Ecole des Mines de St Etienne, France. SIGVARIS Symposium - European Venous Forum 2014

  2. METHODOLOGY 1 VEIN IMAGING Ultra-sounds 12-15 MHZ probe EVF 2014, Paris

  3. METHODOLOGY 1 PRESSURE FLUID type LAPLACIAN type From Lun B., et coll. Physics of compression, definition and evaluation. Phlébologie 2014 ; in press. EVF 2014, Paris

  4. METHODOLOGY 1 5 patients C2EPASPr 12 leg varicosis areas French class 2 MCS (norme AF G 30 102 B) EVF 2014, Paris

  5. RESULTS Rastel D, Lun B. Phlébologie. 2014 ; 67(1) : 40-5. EVF 2014, Paris

  6. RESULTS Effects of a 20 mmHg local pressure exerted by a by a medical compression stocking on superficial veins in 12 varicose veins areas. Rastel D, Lun B. Phlébologie. 2014 ; 67(1) : 40-5. EVF 2014, Paris

  7. METHODOLOGY 2 A NUMERICAL MODEL MRI + Ultra-sound Qualification of physical properties of leg components = literature Rohan P-Y., Badel P., Lun B., Rastel D., Avril S. Biomechanical response of varicose veins to elastic compression : A numerical study. J Biomechanic 2013 ; 46(3) : 599-603. EVF 2014, Paris

  8. RESULTS Trans Mural Pressure = iP – eP aP tP C hP oP rP eP iP 13 Fat tissue behaviour law 10 to 20 % Adapted from Franceschi C., Zamboni P. Principles of Venous Hemodynamics. Nova Biomedical. 2009 and from Rohan P-Y. Thèse de l’Ecole des Mines de Saint-Etienne. 2013. EVF 2014, Paris

  9. RESULTS SCLEROTHERAPY : Reduce the level of micro-thrombectomies and improve results (Kern C., and coll. J Vasc Surg 2007 ; 45 : 1212-1216) No benefit for great saphenous vein foam sclerotherapy (Hamel-Desnos C., and coll. Eur J Vasc Endovasc Surg 2010 ; 39 : 500-507) MCS EVF 2014, Paris

  10. RESULTS FOAM SCLEROTHERAPY Sclerus Incompetent epi-fascial veins Spasm 9 mmHg external pressure 35 mmHg external pressure 13,5 mmHg 48,8 mmHg Diameter : 4mm Depth : 4mm Rohan P-Y. Thèse de l’Ecole des Mines de Saint-Etienne. Etude biomécanique de l’action des bas médicaux de compression sur les veines du membre inférieur. 3 décembre 2013. EVF 2014, Paris

  11. CONCLUSIONS • - In standing position MCS do not reduce significantly epi-fascial vein caliber. • MCS, even at a medium range pressure around 20 mmHg, decrease trans-mural pressure. • External pressure is modulated by the fat tissue behaviour. • Skin inflammation following foam sclerotherapy are more frequently seen for epi-fascial veins than saphenous veins. • So, we hypothesize that MCS, increasing peri-venous pressure, could create a protective environment against local side effects of foam sclerotherapy. EVF 2014, Paris

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