Developments and future outlook
11.11.2017 - Hamburg
About 150 members of the medical profession, therapists and care staff as well as care specialists from the medical retail trade followed Juzo’s invitation to Hamburg to find out more about medical development trends and prospects in phlebology.
Prof. Dr. med. Stefanie Reich-Schupke, holder of the only German chair for Phlebology at Ruhr University in Bochum, created a highly topical programme. Her choice of speakers truly represented the “Who’s Who” of German phlebology. For personal reasons, she had to hand over the leadership of the event to Prof. Dr. med. Anke Strölin, Deputy Senior Consultant at the Department of Dermatology, Tübingen University Hospital, who hosted the event with confidence. The presentations were simultaneously interpreted into English for international visitors.
In her welcoming speech, Prof. Strölin emphasised how topical the presentations were and she was pleased about the interest shown by participants from medical retail and paramedical professions.
The training day was split into three lecture blocks: thromboembolisms, compression, as well as venous leg ulcers and an update on varicose veins.
In the opening presentation “Guideline on preventative measures for venous thromboembolisms – What’s new?”, Prof. Dr. med. Sylvia Hass, Munich, reported on the S3 Guideline, which was updated in 2015. The guideline contains specific recommendations for thrombosis prevention in surgical and outpatient care. According to the guideline, risk assessment is essential, with the thrombosis risk requiring individual evaluation on a patient by patient basis. In special cases, calf-height compression stockings are recommended for thrombosis prevention on long journeys.
The “Guideline for the treatment of venous thromboembolisms – What’s new?” was the focus of the presentation by Prof. Dr. med. Anke Strölin, Tübingen. Each year, around 160,000 patients are diagnosed with deep vein thrombosis in Germany. The estimated number, however, is much higher because only 50 to 60% of all cases present with typical symptoms. The initial treatment is still anticoagulation medication and compression. The option of using direct oral anticoagulants (DOACs) is new in the S2k Guideline. One recommendation of the guideline proposes the early introduction of compression therapy to reduce the frequency and severity of post-thrombotic syndrome (PTS).
The first topics block was rounded off by Prof. Dr. med. E. Sebastian Debus, Hamburg, in his presentation “Treatment of the post-thrombotic syndrome – the state of the art.” If conservative treatment of deep vein thrombosis (DVT) was used on its own, about 90% of patients would suffer from PTS. In order to avoid marked findings, reflux obstruction has to be eliminated. For this, various methods corresponding to the diagnostic findings are available nowadays. These interventional methods have proved to be safe and successful. However, accompanying compression treatment – in most cases for the rest of the patient’s life – is still unavoidable.
The presentation by Justine Whitaker, Clitheroe, UK, elaborated on the question „Can Velcro wrap systems really replace compression bandaging.“ The simple answer is ‘no’ because only some patients can be treated this way. When assessing patients as individuals and taking account of their differentiated diagnoses, however, the answer can be ‘yes.’ Additional research must consider the effect of wrap systems on different connective tissue structures as well as causes of the illness.
In his presentation “Beyond varicose veins – areas of application for modern compression therapy”, Prof. Dr. med. Markus Stücker, Bochum, examined additional areas of application for compression treatment, going beyond phlebology, lymphology and scar therapy. Scientific studies showed that previous contraindications of compression stockings may turn into indications. Under certain conditions, this might be the case for PAD for example, or for specific inflammatory skin disorders.
PD Dr. med. Felizitas Pannier, Bonn, had prepared two presentations. First, she spoke about her positive experience with “Endovenous laser treatment”, which she has been performing successfully for 18 years. Over time, this method has become increasingly gentle. The latest development of the radial emitting laser has also contributed to this. She also pointed out limits of this treatment that preserves the vessels, such as extremely tortuous saphenous veins. In her presentation “Sclerotherapy - and its possibilities”, Dr. Pannier then talked about chemical treatment options for varicose veins. According to her conclusion, sclerotherapy has now become the only treatment that can be used on all varicose veins.
“Update – surgical treatment of varicose veins” was the topic of the presentation by Prof. Dr. med. Achim Mumme, Bochum. In his experience, modern varicose vein surgery results in a high degree of patient satisfaction with very low relapse rates. Surgical planning and technique are critical for this, such as invaginated stripping of the vein. During this particularly gentle technique, the vein, which is to be stripped, is turned inside out. He gave endoluminal valvuloplasty, in a sense a compression stocking around the vein, as another example. His concluding message: “Modern varicose vein surgery: gentle – differentiated – effective – long-lasting.”
As part of the symposium, Sarah Conen, Juzo Phlebology Product Management, presented a donation cheque of 5,000 euros to Prof. Stücker, President of the German Association of Phlebology. With this, Juzo wants to support the work of the “Young Phlebology” task force.
Scientific leaders and organisers were pleased with the good response to this international symposium. The feedback from guests and speakers was positive throughout.
The 3rd International Phlebology Symposium will be held in Munich on 24th November 2018.
Prof. Dr. med. Sylvia Haas, Munich
Specialist for General Medicine
Prof. Dr. med. Birgit Kahle, Lübeck
Department of Dermatology, Allergology and Venereology
Prof. Dr. med. Achim Mumme, Bochum
Director of the Department of Vascular Surgery at St. Josef Hospital
at the Bochum Catholic Hospital – Ruhr University in Bochum
PD. Dr. med. Felizitas Pannier, Bonn
Specialist for Dermatology, Department of Dermatology and Phlebology, Clinic and Polyclinic for Dermatology and Venereology, Cologne University Hospital
Prof. Dr. med. Markus Stücker, Bochum
Senior doctor at the Interdisciplinary Venereology Centre, Managing Director of the Department for Dermatology, Venereology and Allergology, St. Josef Hospital
Around 200 participants were given the opportunity to discuss the interprofessional presentations under the motto “Cross-border phlebology.” The speakers provided information about latest developments in varicose vein therapy – starting with conservative treatments, followed by various surgical techniques and finishing off with treatment methods for venous ulcers.