1st international haemodynamic symposium on venous disorders€¦ · hemodynamic assessment and the...

1st International Haemodynamic

Symposium on Venous Disorders

Haemodynamic aspects of physiopathology,

diagnosis and therapy of the venous disease

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In t roduct ion

In recen t decades we have

w i tnessed a great revo lu t ion in the

approach to venous d iseases thanks to

the inc reas ing unders tand ing o f the

phys iopatho log ic ica l m echan ism s tha t

cause the t yp ica l pa tho log ica l s igns o f

venous insuf f ic ienc ies .

The in t roduc t ion o f non- invas ive

d iagnos t ics w i th the cont inuous wave

Dopp ler and subsequent l y w i th the Echo

Co lor Dopp ler enab led us to acqu i re

deta i led in form at ion on the phys io log ica l

m echan ism s o f venous c i rcu la t ion and

consequent l y on the phys iopa tho log ica l

m echan ism s . Th is a l lowed fo r a new c lose

exam inat ion o f t he events and

hem odynam ic changes tha t t r i gger the

onset o f the c l i n ica l abnorm al i t ies

charac ter is t ic o f venous insuf f ic ienc ies .

Th is deve lopm ent has great l y

benef i t t ed d iagnos is and therap y not on l y

o f the super f ic ia l venous insuf f ic ienc ies

but a lso o f the deep venous

insuf f ic ienc ies , wh ich are common in

pos t - th rom bos is synd rom e.

In the las t twenty - f ive years , non - invas ive

hem odynam ic u l t rasound d iagnos t ics together w i th

techno log ica l deve lopm ents have broade ned therapeu t ic

op t ions . These inc lude conserva t i ve hem odynam ic therapy

and a lso the progress ive deve lopm ent o f d i f f e rent f o rm s o f

m in im al l y - invas ive therap ies wh ich in tend to o f fe r

a l te rnat i ves to s t r ipp ing tha t a re eas ier to im p lem ent .

Scientific Board

Prof. Livio Gabrielli

Prof. Claude Franceschi

Dott. Roberto Delfrate

The hem odynam ic CH IVA s t ra teg y (Conservat r ice e t

Hem odynam ique de l ' Insu f f isance Ve ineuse en Am bula to i re )

cod i f ied by C laude Francesch i , a p ioneer who p la yed a m ajor

ro le in the deve lopm ent and spread ing o f the Dopp ler

u l t rasound vascu lar inves t iga t ion both in the ar te r ia l and

venous d is t r ic ts , appeared in 1988 as an a l te rnat i ve to

dem ol i t i on therap ies . I t ’ s p r im ary a im was to preserve

saphenous ve ins in ever y pat ien t f o r any poss ib le fu r ther

vascu lar use and wh i le m ain ta in ing proper t issue dra inage.

The hem odynam ic CHIVA s t ra tegy requ i res rem arkab le

d iagnos t ic sk i l l s and cons tant p rac t ice and perseverance in

order to f u l l y exp lo i t t he d iagnos t ic po tent ia l o f the Echo Co lor

Dopp ler . Thanks to these e f fo r ts i t has been poss ib le to

inc rease the unders tand ing o f the phys iopatho l og ica l

m echan ism s o f venous insuf f ic ienc ies o f the lower l im bs and

to expand therapeut ic hor i zons as in the case o f the var icose

ve ins o f pe lv ic o r ig in .

A l l t h is a l lowed fo r t he app l ica t ion o f new hem odynam ic

knowledge to the ar te r ia l d is t r ic t as we l l , w i t h severa l benef i ts

f o r pa t ien ts su f fe r ing f rom ar te r ia l occ lus ive d isease ar is ing

f rom the deve lopment o f a therosc lero t ic l es ions and

espec ia l l y f rom d iabet ic a r te r iopath y. An exam ple is the

poss ib i l i t y o f m easur ing the ar te r ia l p ressu re in t he vascu lar

bed o f the fo re foot (Po le tes t ) o r i n the t ib ia l ve ins o f the

ank le , tak ing advantage o f the bas ic pr inc ip les o f ph ys ics ,

w i th an Echo Co lor Dopp ler o r a s im ple pu lse ox im eter .

The def in i t i on o f the concept o f a shunt and the

poss ib i l i t y o f c lass i f y ing hem od ynam ic events in an y t ype o f

shunt enab led us to deve lop and im plem ent new hem odynam ic

cor rec t ive therap ies not on l y o f the super f ic ia l ve in bu t a lso

o f deep ve ins . The a im o f these therap ies is to norm al i ze

t ransm ura l p ressure va lues in t he super f ic ia l d i s t r ic ts and

under the fasc ia , s tandard iz ing the t rea tm ent accord ing to the

t ype o f shunt .

As far as deep venous insuf f ic ienc ies , thanks to

hem odynam ic assessm ent and the contem porary deve lopm ent

of new recons t ruc t ive and endovascu lar techn iques , toda y i t ’ s

poss ib le to face the com plex prob lem of deep venous

insuf f ic ienc ies l ike pos t - th rom bos is syndrom e wi th m ore

opt im ism and a h ighe r success ra te .

Vascu lar m al fo rm at ion pa tho log y has a lso been

pos i t ive l y a f fec ted by the progress b rought about by

inc reas ing a wareness o f hem odynam ic Echo Co lor Dopp ler

d iagnos t ics . Togethe r wi th the poss ib i l i t y o f p re -surgery

assessm ent , the use o f u l t rasounds dur ing opera t ions has

rem arkab ly inc reased the success ra tes o f th is therap y.


Director of the Postgraduate course on Vascular Surgery at

the University of Milan

Head of the Vascular Surgery Unit of the IRCCS Cà Granda

Foundation –Maggiore Policlinico Hospital

Prof. Claude Franceschi

Consultant in vascular pathology, complex venous insufficiency and

vascular malformations Saint Joseph Hospital, Paris

Director of the diplôme d'Ecodoppler vasculaire Groupe hospitalier

Pitié-Salpêtrière University of Paris VII, Paris

Medical Consultant Private Clinic - Figlie di San Camillo, Cremona

Dott. Roberto Delfrate

Head of the Surgery Department and of the Surgery Unit at the

Private Clinic Figlie di San Camillo in Cremona

1st International Haemodynamic

Symposium on Venous Disorders

Hemodynamic aspects of physiopathology,

diagnosis and therapy of the venous disease

The symposium cons is ts of two days of in -depth s tudy dur ing which

the fundamental concepts of the phys iopathology of the superf ic ial

and deep venous d isease and of venous malformat ion wi l l be

expla ined.

Except ional ly exper ienced profess ionals wi l l gather to analyze the

d if ferent approaches to the venous disease, to examine the aspects

of physiopathology and provide in -depth, exper t informat ion and

updates.

Lecturers f rom dif ferent backgrounds wi l l take tu rns at the podium

and wi l l compare their exper iences dur ing the var ious sess ions. A

l ive examinat ion wi th Echo Color Doppler wi l l be carr ied out on

pat ients af fected by the venous d isease and the concepts expressed

by the lec turers wi l l be put in to pract ic e.

I t wi l l be an extraordinary occas ion for any phys ic ian who wants to

develop and update their sk i l ls thanks to the latest knowledge in the

f ie ld of venous diseases af fect ing the western populat ion more and

more .

Target audience

I ta l ian and fore ign physic ians.

Target medical disciplines: angiology, general surgery, vascular surgery,

diabetology, gynecology and obstetrics, dermatology, cardiology, vulnology,

emergency medicine, internal medicine, sports medicine, radiology, neurology,

general medicine.

Italian and foreign resident doctors of the above-mentioned disciplines.

Scient if ic Board

Dott. Roberto Delfrate Cremona

Prof . Claude Franceschi Par is

Prof . Livio Gabriel l i Milan

Educational objectives:

The main object ive of this symposium is to d iscuss the latest

advancements in venous phys iopathology, which involves complex

hemodynamic concepts, and to provide phys ic ians wi th the sk i l ls to

perform advanced hemodynamic d iagnost ics by improving the overal l

s tandard of the Echo Color Doppler examinat ions. Another impor tant a im

is to promote the pract ice of look ing for the most sui table treatment,

star t ing wi th the prognos is , fo l lowed by the development of a rat ional

therapeut ic s trategy based on the examina t ion of evidence and knowledge

of phys iopathology.

Below is a deta i led l is t of the symposium’s object ives:

To promote the d iagnost ic potent ia l of the new ul tra -sonographic

technologies and the implementat ion modal i t ies of the diagnos is wi th

the use of hemodynamic maneuvers and car tographic maps.

To examine the dif ferent f ie lds of appl icat ion of the new hemodynamic

phys iopathological knowledge in depth. These f ie lds inc lude:

Superf ic ia l venous insuf f ic ienc ies;

Venous insuf f ic ienc ies of pelv ic or ig in;

Vascular malformat ions;

Deep venous insuf f ic ienc ies;

Venous u lcers of the lower l imbs;

To know and compare d if ferent therapies:

Sc lerotherapy;

Saphenectomy;

Endoluminal therapies;

CHIVA;

Surgical therapies and treatment of the var icose veins of pelv ic

or ig in;

Surgical therapies of vascular malformat ions;

The treatment of deep venous insuf f ic iencies: f rom stents to

valvuloplast ies and CHIVA correct ions

The treatment of u lcers of the lower l imbs

Elastocompressive venous d isease therapies

The need for post-surgery ant icoagulant therapies for a br ief or

medium per iod af ter the treatment of deep and superf ic ia l venous

insuf f ic ienc ies

The ro le of medical therapy today

Format:

The course is accredited by the I ta l ian Accreditat ion Counc i l for Cont inuing

Medical Educat ion (ECM) and cons ists of two days and 10 sess ions, dur ing

which there wi l l be two lec t io ns magistra l is , a f ina l recap sess ion and a

l ive sess ion f rom the examinat ion room of the Hospi ta l Maggiore

Pol ic l in ico of Mi lan wi th the u l trasound examinat ion of two pat ients .

Each sess ion consis ts of :

Lecture of one member of the faculty

Guided debate with one or more discussants

12 Credit i ECM reference number 351-135480

Conduttori , Relatori e Discussant

Prof . Giovanni Bat t is ta Agus Milano

Full Professor of Vascular Surgery at the University of Milan

Vascular Surgery and Angiology Private Practice

Prof . Amine Bahnin i Par ig i

Head of the Department of Vascular Pathology of the American Hospital of Paris

Associate Professor in the Phlebology track at the University Pierre et Marie Curie, Paris

Dott .ssa Vit tor ia Barald in i Milano

Surgeon specialized in Pediatric Surgery and Vascular Surgery at the Center for Child Angiomas and Vascular Malformations at the “V.Buzzi” Children’s Hospital in Milan

Prof . Stefano Bianchi Milano

Head of the Multi-Specialty Department of Obstetrics and Gynecology and of the Maternal-Infant Department at the

Hospital San Giuseppe in Milan

Associate Professor in charge of the Obstetrics and Gynecology track at the University of Milan

Prof . Piero Bonadeo Tortona

Head of the Department of Day Surgery and Vascular Surgery at the Hospital of Tortona (Alessandria)

Dott . Massimo Br icchi Cremona

Assistant Medical Director of the Department of General Surgery at the Private Clinic Figlie di San Camillo in Cremona

Prof . Massimo Cappel l i Firenze

Self-employed physician with Angiology and Phlebology Private Practice in Florence.

Adjunct Professor at the Clinical Research Centre of the University of Camerino

Prof . Giacomo Cler ic i Pavia

Head of the Centre for the Treatment of Diabetic Foot at the Istituto di Cura Città di Pavia – University of Pavia

Dott . Roberto Delf rate Cremona

Head of the Surgery Department and of the Surgery Unit at the Private Clinic Figlie di San Camillo in Cremona

Prof . Maur izio Domanin Milano

Assistant Director of the University Department of Vascular Surgery at the IRCCS Cà Granda Maggiore Policlinico Hospital of Milan

Adjunct Professor of the Postgraduate Specialty Course of Vascular Surgery at the University of Milan

Prof . Stefano Ermini Firenze

Self-employed physician with Phlebology Private Practice in Grassina - Florence

Contract Professor of Hemodynamic Phlebology at the University of Camerino.

Dott . Guglie lmo Fornasar i Cremona

Vascular Surgeon, - Consultant at the Private Clinic “Figlie di San Camillo” – Cremona

Prof . Claude Franceschi Par ig i

Consultant of Vascular Pathology, Complex Venous Insufficiency and Vascular Malformation, Hospital Saint Joseph, Paris

Director of the Echo Color Doppler Certificate Program at the University Hospital Petié-Salpêtrière University Paris VII, Paris

Consultant at the Private Clinic Figlie di San Camillo in Cremona

Prof . L iv io Gabr ie l l i Milano

Director of the Postgraduate course on Vascular Surgery at the University of Milan

Head of the Vascular Surgery Unit of the IRCCS Cà Granda Foundation –Maggiore Policlinico Hospital

Prof .ssa Mi lka Greiner Par ig i

Assistant Director of the Interventional Vascular Radiology Ward at the American Hospital in Paris

Doctor of the Cardio-vascular and Interventional Radiology Department at the Hospital Petié-Salpêtrière in Paris

Lecturer of Vascular Medicine at the University Pierre et Marie Curie, Paris

Dott . Salvatore Laganà Salò

Assistant Director of the Department of General Surgery at the Hospital Enterprise of Desenzano del Garda – Hospital of Gavardo

Prof . Oscar Malet i Modena

Head of the Department of Vascular Surgery at Hesperia Hospital in Modena

Head of research on new biomedical phlebology products at the Research Centre “Math for Technology, Medicine and

Biosciences” at the University of Ferrara

Dott . Fausto Passar ie l lo Napol i

Self-employed Vascular Surgeon at the Practice Aquarius - Naples

Dott . Riccardo Picc io l i Crema

Self-employed Surgeon in the Department of General and Vascular Surgery at the Medilaser Practice in Crema (Cremona)

Dott . Mauro Pinel l i Avezzano

Head of the Department of Angiology and Vascular Diagnostics at the Hospital of Avezzano (L’Aquila)

Prof . Jorge Juan Samsò Barcel lona

Director of the Vascular Lab of the Diagnostic unit Platón at the University Hospital of Barcelona

Dott . Gianni Vercel l io Milano

Vascular Surgeon and Angiologist, Consultant at the Italian Diagnostic Centre of Milan.

Coordinator of the Center for Angiomas and Vascular Malformations of at Niguarda Cà Granda Hospital in Milan

Prof . Mark W hite ley Londra

Vascular Surgeon, Director of “The Whiteley Clinic” - London

External faculty member at the University of Surrey

Date and venue: Maggiore Pol iclinico Hospital of Milan

Aula Magna of the Mangiagal l i C l in ic

Via Commenda, 12 Mi lan

October 15 and 16, 2015

Maximum number of attendees:

The course cannot be at tended by more than 150 phys ic ians

Learning material

Attendees wi l l be g iven the fol lowing texts wr it ten by Dr Roberto Delfrate :

A new approach to varicose veins:

haemodynamic evaluation and treatment

Lorena Dioni Publ isher 2014

Cover pr ice € 90,00

Nuovo approccio diagnost ico

al le vene varicose

Lorena Dioni Publ isher 2014

Cover pr ice € 16,00.

Ext ract f rom the prefaces of prof . L i v io Gabr ie l l i

“In Vascular Surgery training, knowledge of haemodynamics is a basic requisite for the

education of residents. This knowledge is the basis of a full understanding of the clinical

manifestations of both arterial and venous diseases.

In many aspects the venous system is far more complicated than the arterial system due

to its anatomical network complexity, the existence of the muscle pumps that allow for the

return of blood to the heart against forces of gravity and the presence of competent or

incompetent valves in the vessels.”


Fees

Registrat ion fee: € 350,00 + VAT. I t includes:

Admission to a l l sess ions

Course mater ia l ;

Dai ly “ l ight lunch”

Administrative Off ice

Lorena Dioni medical sc ient i f ic publ icat ions and train ing Folgar ia (Trento) phone: 348-7691268

e.mai l : lorenadioni@haemodynamicsdelf rate.com

Scient if ic Office Maur izio Domanin

Lorena Dioni

How to reach the conference venue

Clinica

Mangiagalli

mailto:[email protected]

Program

Thursday, October 15, 2015 – Morning Sess ion

8.30

Regis tra t ion

9.00

1. New basics of venous phys iopatholog y

1 . 50 ’

1.1 . In t ra - and ex t ra -p ressu re. Trans mura l pressure Cl a u d e Fr a n ce s c hi 2 0 ’

1.2 . The phys io logy o f venous re turn M a ur o P i n e l l i 2 0 ’

1.3 . The concept and c lass i f i ca t ion o f shunts J or g e J u a n S am s ò 2 0 ’

1.4 . Per fo ra t ing ve ins S t e fa n o E r m i n i 2 0 ’

Debate

M od e r a t o r :

L iv i o G a br i e l l i

Dis c us sa n t :

M as s im o C a p pe l l i

3 0 ’

10.50

2. Hemod ynamic d iagnost ics

1 . 20 ’

2.1 . S tandard Echo Color Doppler tes t Ro b er t o D e l f r a te 1 0 ’

2.2. The choice of valvular diagnost ics test and its meaning S t e fa n o E r m i n i 2 0 ’

2.3 . Hemodynamic Car tography , sys to l i c and d ias to l i c

aspec ts

M as s im o C a p pe l l i 2 0 ’

Debate

M od e r a t o r :

M a ur i z i o D om a n i n

Dis c us sa n t s :

J or g e J u a n S am s ò

G u gl i e lm o F or na s ar i

3 0 ’

12.10

3. The inner saphenous vein , an instrument fo r the

surgeon

1 . 10 ’

3.1 . The d iabet ic foot and d iabet ic ar te r iopathy o f the

lower l imbs

Gi a c om o C le r i c i 2 0 ’

3.2 . The inne r saphenous ve in as a source o f vascu lar

gra f t : upg rade

S a lv a t or e L a g a nà 1 0 ’

3.3 . The h is to l og ica l qua l i t y o f the saphenous ve ins

prese rved w i th CHIVA t rea tment

Ro b er t o D e l f r a te 1 0 ’

Debate

M od e r a t o r :


Dis c us sa n t s :

Am i n e B a h ni n i

C l a u d e Fr a n ce s c hi

3 0 ’

Ore 1.20

Light Lunch

Program

Thursday, October 15, 2015 – Afternoon Session

2.20

Lect io magistra l is

Elas tocompress ion: ove rv i ew of the

e las tocompress ion the rapy o f the venous d iseas e

Cl a u d e Fr a n ce s c hi 2 0 ’

2.40

4. Vascular mal format ions

1 . 30 ’

4.1 . Phys iopatho log ica l f ramework and the rapeut ic

overv iew


4.2 . Surg ica l t reatment o f vascu la r mal fo rmat ions Gi a n n i V er c e l l i o 2 0 ’

4.3 . Hemodynamic surg ica l t rea tment o f venous

mal f ormat ions


Debate

M od e r a t o r :

V i t t or i a Bar a l d i n i

Dis c us sa n t :


3 0 ’

4.10

5. Venous insuff ic i enc y o f the pelv is

1 . 5 0 ’

5.1 . Phys iopatho logy and d iagnos is o f the pe lv ic

var icoce le

M ar k W h i t e l e y 2 0 ’

5.2 . Surg ica l t reatment o f the pe lv ic var icoce le Am i n e B a h ni n i 2 0 ’

5.3 . Endovascu la r t reatment o f the pe lv ic var icoce le M i l k a Gr e i n er 2 0 ’

5.4 . The var icose ve ins o f the l ower l imbs o f pe lv ic

or i g in


Debate

M od e r a t o r :

Gi o v a n ni B a t t i s ta A g u s

Dis c us sa n t s :

S t e fa n o B i a nc h i

S a lv a t or e L a g a nà

3 0 ’

6.00

End of the f i rs t da y

Program

Friday, October 16, 2015 – Morning Sess ion

8 .30

6. Hemod ynamic d iagnost ics and cartograph y

2 . 2 0

Live f rom the examinat ion rooms of the Graduate

School o f Vascu la r Su rge ry o f the Unive rs i t y o f

M i lan

I n t h e d o c t o r ’ s o f f i ce :

Ro b er t o D e l f r a te

I n t h e c o n f e re n ce r oo m:

C l a u d e Fr a n ce s c hi

2 . 0 0 ’

Debate

M od e r a t o r :


Dis c us sa n t s :

J or g e J u a n S am s ò

G u gl i e lm o F or na s ar i

2 0 ’

10.50

7. Pursuing the best therapeut ic strateg y in

pr imi t ive var icose veins of the lower l imbs

wi thout an y sort o f in tegral ism

2 . 10 ’

7.1 . CHIVA and the reasons for prese rv ing t he

saphenous ve in

S t e fa n o E r m i n i 2 0 ’

7.2 . Hemodynamic aspec ts in sc lero thepathy Ri c car d o P ic c i o l i 2 0 ’

7.3 . Saphenec tomy M a ur i z i o D om a n i n 2 0 ’

7.4 . Endolumina l the rap ies Gi o v a n ni B a t t i s ta A g u s 2 0 ’

7.5 . CHIVA-Laser : poss ib i l i t i es and pers pec t ives F a us t o P a ss ar ie l l o 2 0 ’

Debate

M od e r a t o r :


Dis c us sa n t s :

Cl a u d e Fr a n ce s c hi


3 0 ’

1 .00

Light Lunch

Programma

Friday October 16, 2015 – Afternoon Session

2.00

Lect io magistra l is

Medica l therapy o f venous insuf f i c ienc ies

P i er o B o na d e o 2 0 ’

2.20

8. Deep venous insufficiencies: diagnosis, t reatment

and post-surgery management of the patient

1 . 20 ’

8.1 . The phys iopatho log ica l assessment and t he

benef i t s o f the CHIVA t reatment


8.2 . The t reatment o f deep venous insuf f i c ienc ies : f rom

s tents to va lvu lop las t ies

Os c ar M a l e t i 3 0 ’

Debate

M od e r a t o r :


Dis c us sa n t s :


M a ur o P i n e l l i

2 0 ’

3.40

9. Venous ulcers o f the lower l imbs

1 , 20 ’

9.1 . Phys iopathog ica l assessment M as s im o Br ic c h i 2 0 ’

9.2 . Therapeut ic deta i l s in the venous u lce rs P i er o B o na d e o 2 0 ’

9.3 . A l ternat ives to modern dress ings in the t reatment o f

u lcers in the lower l imbs

M as s im o Br ic c h i 2 0 ’

Debate

M od e r a t o r :


Dis c us sa n t :

S a lv a t or e L a g a nà

2 0 ’

5.00 10. F inal Recap Session

10.1 . Perspec t ives on the hemodynamic approach to

venous d iseases


40 ’

2 0 ’

Debate

M od e r a t o r :


Dis c us sa n t s

Cl a u d e Fr a n ce s c hi


2 0 ’

5.40

Closing Remarks


10 ’

5.50

CME Test

This conference was made possible by the unconditional educational support of:

And with the support of

1st international haemodynamic symposium on venous disorders€¦ · hemodynamic assessment and the...

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