Short Biography Information
Dr. Nicolas Neaume is a highly accomplished interventional vascular physician with an impressive tenure of 25 years in the field. Currently stationed at the prestigious Pasteur Clinic in Toulouse, France, Dr. Neaume has played a pivotal role in establishing an innovative interventional phlebology centre in collaboration with his esteemed associates. Within this centre, they employ state-of-the-art techniques, including laser, radiofrequency, glue, and onyx, to successfully treat over 1000 varicose veins and venous malformations each year.
Beyond his expertise in the operating theatre, Dr. Neaume also spearheads activities in sclerotherapy and provides consultations for venous and arterial ultrasound-doppler procedures. Recognizing the importance of fostering the growth of future medical professionals, Dr. Neaume and his team are actively engaged in training activities for young colleagues, ensuring the transmission of knowledge and skills. Additionally, he is involved in clinical research, constantly seeking to advance the field of interventional vascular medicine. Dr. Neaume’s commitment to his profession is further exemplified by his long-standing membership in the esteemed French Society of Phlebology. His peers have bestowed upon him the honour of being elected President for the forthcoming three years, a testament to his expertise, leadership, and dedication to the advancement of vascular medicine.
Can you describe a particularly challenging case you’ve encountered in your practice as a phlebology surgeon and how you approached it?
I remember a case, a dental colleague who had already been treated four times (surgery, sclerosis) and that no one wanted to take care of him because of permanent recurrences. He presented with ulcers secondary to his varicose pathology and was wearing his daily compression. After an echodoppler examination of his leg, no thermal endovenous technique was feasible and he no longer wanted surgery or sclerosis. We decided with his agreement to treat his perforating veins feeding the ulcer and his main recurrences by multiple glue punctures under ultrasound: “Ultrasound Guided Glue Therapy”. The result was a success, the patient did not relapse his ulcerous varicose pathology, and this allowed me to develop my first research protocol in CEAP 6 stages and treatment with glue whose results I will present in 2024.
What new developments or advancements in Venous surgery are you most excited about, and how do you think they will improve patient outcomes?
Since the beginning of the 21st century, the arrival of minimally invasive endovenous techniques has been a real revolution in the management of our patients. In parallel to the major progress obtained thanks to thermal endovenous techniques, for a few years now non-thermal, non-tumescent techniques have been appearing, with very promising results and allowing us to free ourselves from potential per operative pain and also from the risks of nerve damage. The aim of an interventional phlebology centre is to be able to offer all the techniques to treat the right patient with the right method. In order to improve patient results, we must train our young doctors well, inform our patients well, and standardise our endovenous techniques as much as possible so that they can be reproduced by all practitioners.
What advice would you give to patients who are considering Venous surgery, and how can they prepare themselves for the procedure and recovery?
My advice is very simple as we perform all our procedures on an outpatient basis, without general anaesthesia or neuroleptanalgesia (which should no longer be practised nowadays), but simply under peri-venous tumescence for thermal ablations and under EMLA cream for non-thermal ablations such as glue. The patients benefit from the operation in the operating theatre and leave 30 minutes later. They return to work the next day and to their physical and sporting activities a week later in general. So overall I ask them not to change their habits in relation to the operation.
In your opinion, what sets phlebology apart from other surgical specialities, and what drew you to this field?
Phlebology is a transversal speciality which allows the practitioner to be present at all stages of the treatment, from the physical examination to the final interventional treatment, including the echo-doppler diagnosis. It is in full evolution, even revolution with the new techniques. Venous disease concerns a large proportion of the world’s population and it is an honour to be able to help them by improving their quality of life. My interest in phlebology came about through the many encounters I had during and after my studies, and because of the possibility of being able to take care of my patients globally.
How do you see the future of phlebology evolving, and what role do you see technology and innovation play in this evolution?
After having been neglected by our university authorities, phlebology has a bright future and many people are interested in it. The progress of techniques, imaging and clinical research allow us to understand venous pathology and its haemodynamics better and better. It remains to include a little artificial intelligence and we will probably make further progress in our treatments, which will be more durable and will therefore reduce recurrences and the evolution towards harmful CEAP stages.