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Advancements in Venous Disease Management: From Conservative to Interventional Treatments
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Advancements in Venous Disease Management: From Conservative to Interventional Treatments

A special issue of Journal of Clinical Medicine (ISSN 2077-0383). This special issue belongs to the section "Vascular Medicine".

Deadline for manuscript submissions: 30 September 2025 | Viewed by 2259

Special Issue Editors

Dr. Daniele Bissacco

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Guest Editor
Department of Clinical Sciences and Community Health, University of Milan, Milan, Italy
Interests: vascular surgery; vascular medicine; phlebology; angiology
Special Issues, Collections and Topics in MDPI journals
Dr. Chiara Lomazzi

E-Mail
Guest Editor
Vascular Surgery Unit, IRCCS Ca’ Granda Ospedale Maggiore Policlinico, Milan, Italy
Interests: vascular surgery; vascular medicine; phlebology; angiology

Special Issue Information

Dear Colleagues,

This Special Issue aims to explore the significant advancements in venous disease management, highlighting the transition from traditional conservative approaches to innovative interventional techniques. Cutting-edge technologies, evidence summaries, and new insights from lifestyle modifications, compression therapies, pharmacological interventions, and endovascular techniques for both superficial and deep venous systems will be welcome as part of thiis special article collection. Moreover, advancements in imaging technologies, particularly duplex ultrasound, computed tomography angiography, and intravascular ultrasound technology, have enhanced diagnostic accuracy, facilitating the development of tailored treatment plans. This issue will feature original research and reviews that examine the plethora of conservative and interventional strategies, aiming to optimize patient outcomes. As research continues to evolve, the future of venous disease management promises refined techniques and interdisciplinary approaches, underscoring the importance of comprehensive care that addresses both the physical and psychological impacts of venous disorders.

Dr. Daniele Bissacco
Dr. Chiara Lomazzi
Guest Editors

Manuscript Submission Information

Manuscripts should be submitted online at www.mdpi.com by registering and logging in to this website. Once you are registered, click here to go to the submission form. Manuscripts can be submitted until the deadline. All submissions that pass pre-check are peer-reviewed. Accepted papers will be published continuously in the journal (as soon as accepted) and will be listed together on the special issue website. Research articles, review articles as well as short communications are invited. For planned papers, a title and short abstract (about 100 words) can be sent to the Editorial Office for announcement on this website.

Submitted manuscripts should not have been published previously, nor be under consideration for publication elsewhere (except conference proceedings papers). All manuscripts are thoroughly refereed through a single-blind peer-review process. A guide for authors and other relevant information for submission of manuscripts is available on the Instructions for Authors page. Journal of Clinical Medicine is an international peer-reviewed open access semimonthly journal published by MDPI.

Please visit the Instructions for Authors page before submitting a manuscript. The Article Processing Charge (APC) for publication in this open access journal is 2600 CHF (Swiss Francs). Submitted papers should be well formatted and use good English. Authors may use MDPI's English editing service prior to publication or during author revisions.

Keywords

  • chronic venous disease
  • varicose veins
  • venoactive drugs
  • saphenous vein
  • venous stent
  • iliac vein
  • compression therapy
  • venous insufficiency

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Published Papers (2 papers)

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Research

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10 pages, 1181 KiB  
Article
Treating Popliteal Fossa Perforating Vein Varicosis with Endovenous Laser Ablation: A Single-Center Observational Study
by Lars Müller, Isabel Schmitz-Rode, Bachar el Jamal, Syrus Karsai and Eike Sebastian Debus
J. Clin. Med. 2025, 14(10), 3524; https://doi.org/10.3390/jcm14103524 - 18 May 2025
Viewed by 228
Abstract
Background: Treating varicosities originating from a popliteal fossa perforating vein (PFPV) is challenging due to their proximity to nerves and complex morphology. Data on endovenous laser ablation (EVLA) for PFPV varicosis are limited. Methods: This retrospective, single-center study reviewed all primary varicose vein [...] Read more.
Background: Treating varicosities originating from a popliteal fossa perforating vein (PFPV) is challenging due to their proximity to nerves and complex morphology. Data on endovenous laser ablation (EVLA) for PFPV varicosis are limited. Methods: This retrospective, single-center study reviewed all primary varicose vein surgeries from May 2021 to December 2024. Only primary PFPV varicosis cases with CEAP stage C2s or higher were included. Patients with recurrent disease or primary truncal insufficiency due to reflux from the saphenopopliteal junction were excluded. EVLA was performed using 1470 nm radial laser catheters, targeting the reflux source and downstream varicose segments. Tumescent solution was applied to protect the surrounding structures. The primary outcome was early technical success via duplex ultrasound; the secondary outcome was the complication rate. Results: Of the 2375 limbs treated, 44 (1.9%) involved PFPV. The cohort included 16 men (36%) and 28 women (64%), with a mean age of 54. The median follow-up was 14 days. Technical success was achieved in 41 cases (93.2%). Foam sclerotherapy with polidocanol was performed in eight patients (18.2%), exclusively for superficial residual varicosities and never simultaneously with EVLA. Three treatment failures required re-operation, two of which were successfully re-treated. Minor postoperative complications occurred in two patients (4.5%). No nerve injuries or thrombotic events were observed. Conclusions: EVLA shows promising very early technical efficacy, with low morbidity, for treating PFPV varicosis. Based on our findings, prospective studies investigating the mid- and long-term outcomes of this technique are warranted to further validate its clinical utility. Full article
(This article belongs to the Special Issue Advancements in Venous Disease Management: From Conservative to Interventional Treatments)
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Review

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11 pages, 440 KiB  
Review
Topical Heparin and Heparinoid-Containing Products as Treatments for Venous Disorders: Compounds, Effects, Clinical Implications, and Recommendations
by Daniele Bissacco, Chiara Pisani, Gianraffaele Avallone and Ilenia D’Alessio
J. Clin. Med. 2025, 14(6), 1859; https://doi.org/10.3390/jcm14061859 - 10 Mar 2025
Viewed by 1791
Abstract
Background: Although considerable data are available on oral venoactive drugs, very little information has been published on the types and outcomes of topical treatments for venous disease (VD). This comprehensive review assesses the efficacy and safety of topical heparin and heparinoid-containing products [...] Read more.
Background: Although considerable data are available on oral venoactive drugs, very little information has been published on the types and outcomes of topical treatments for venous disease (VD). This comprehensive review assesses the efficacy and safety of topical heparin and heparinoid-containing products (HCPs) for VD treatment. Methods: This narrative review adhered to established methodologies and standards, utilizing the Scale for the Assessment of Narrative Review Articles (SANRA) for quality assessment. A comprehensive literature search was conducted across MEDLINE (PubMed), Scopus, and Web of Science, covering publications from January 1, 1950, to December 1, 2024. Findings were presented in a narrative format, following structured recommendations to ensure clarity and coherence. Results: Topical heparin and HCPs provide anticoagulation, enhance microcirculation, and regulate skin permeability, with effects influenced by the concentration and formulation. While they effectively improve skin microcirculation in healthy individuals, research on their intracellular effects is limited. Mucopolysaccharide polysulfate (MPS) in heparinoids offers similar vascular benefits and promotes antithrombotic and anti-inflammatory actions. Moisture and gentle abrasion enhance heparin absorption. Topical heparin and HCPs effectively treat superficial vein thrombosis (SVT) and varicose veins (VVs). Products like Hirudoid significantly alleviate SVT symptoms, including pain and swelling. Clinical trials demonstrate substantial symptom improvement with heparin gel (1000 IU/g). For varicose veins, Xioglican cream stabilizes symptoms and improves quality of life, while other formulations like Essaven Gel and Venoruton enhance microcirculation. Conclusions: Managing VD with topical treatments is complicated by the outdated literature and inconsistent methodologies. There is a clear need for systematic research to establish guidelines on the administration, dosage, and frequency of topical treatments. The recommendations in this review aim to provide a foundation for future studies to improve the management of SVT and VVs disease. Full article
(This article belongs to the Special Issue Advancements in Venous Disease Management: From Conservative to Interventional Treatments)
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