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                             Veins and Lymphatics 2018; volume 7:7233

[page 22]                                                          [Veins and Lymphatics 2018; 7:7233]

A renewed interest for surgery
of the large veins
Norman M. Rich
Department of Surgery, Uniformed
Services University of the Health
Sciences & the Walter Reed National
Military Medical Center, Bethesda, 
MD, USA

The Editors of the book-text Latest
frontiers of hemodynamic, imaging, treat-
ment of obstructive venous disease have
written a thorough current review of diag-
nosis and management of challenges associ-
ated with and emphasizing the large veins
of the body.1 The twenty nine chapters
cover a wide variety of subjects and the
accompanying references offer the opportu-
nity for further review and study.
Accompanying graphic illustrations add
additional information and clarification to
the written material.

The chapter titles allow rapid access to
specific areas of interest in the venous sys-
tem. Contributors are established physi-
cians and surgeons with extensive experi-
ence in managing problems in the venous
system including clinical research. That is a
most timely contribution with increasing
worldwide appreciation of the importance
of the venous system in maintaining good

health. 
William Harvey, an Englishman who

had studied in Italy at Padua University
with Fabricius where he earned his Doctor
of Medicine in 1602 taught us about circu-
lation in the Seventeenth Century empha-
sizing the important role of the venous sys-
tem. His classic book MOTU CORDIS was
published in 1628. Yet, and particularly in
the Twentieth Century with the many excit-
ing discoveries in treating problems associ-
ated with the arterial system, the venous
system was ignored in great part as noted in
the United States. This has changed in the
past twenty five years with multiple new
efforts through the American College of
Phlebology and the American Venous
Forum augmenting and complimenting sim-
ilar well established activities in similar
societies throughout the World.2

The Vietnam Vascular Registry estab-
lished in 1966 at Walter Reed General
Hospital in Washington, D. C. provided an
early emphasis on the repair of large veins,
particularly in the lower extremities, rather
than the traditionally accepted ligation.
Statistics of follow up support the absence
of increased thrombophlebitis and of pul-
monary embolism with long term patency
assured have resulted in increased accept-
ance of this approach.3,4

A study published in 2017 Journal of
Vascular Surgery Venous and Lymphatic
Disorders from Johns Hopkins Hospital in
Baltimore, Maryland draws attention to the

perceived weakness in venous education in
vascular surgery trainees in the United
States.5 This book by Zamboni, Veroux,
Lee, Setacci and Giaquinta will contribute
immensely to educating the next generation
of physicians and surgeons in the evaluation
and treatment of venous disorders.

Norman M. Rich,
MD, FACS

References
1. Giaquinta A, Lee BB, Setacci C, et al.

Latest frontiers of hemodynamic, imag-
ing, treatment of obstructive venous
disease. Torino: Minerva Medica; 2018.

2. Bresadola M. The Bassi Historical
International Library of Phlebology at
the Ferrara University Hospital. Veins
and Lymphatics 2014;3:4150.

3. Rich NM, Elster EA, Rasmussen TE.
The Vietnam Vascular Registry at 50
years: An historical perspective and
continuing legacy. J Trauma Acute Care
Surg 2017;83:S4-8. 

4. Hata KW, Propper B, Rich N. Fifty-year
anniversary of the Vietnam Vascular
Registry and a historic look at vascular
registries. J Vasc Surg 2017;65:267-70.

5. Hicks CW, Abularrage C, Heller J. The
State of Venous Education in Vascular
Residency Programs: a Resident
Questionnaire. J Vasc Surg Venous
Lymphat Disord 2017;5:160-1.

Correspondence: Norman M. Rich,
Department of Surgery, Uniformed Services
University of the Health Sciences & the
Walter Reed National Military Medical
Center, Bethesda, MD, USA. 
Tel.: +1.301.295.3707. 
E-mail: norman.rich@usuhs.edu

This work is licensed under a Creative
Commons Attribution 4.0 License (by-nc 4.0).

©Copyright N.M. Rich, 2018
Licensee PAGEPress, Italy
Veins and Lymphatics 2018; 7:7233
doi:10.4081/vl.2018.7233

Figure 1. The cover of the new book Latest frontiers of hemodynamic, imaging, treatment
of obstructive venous disease.

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