Epidemiology: Prevalence

Save this PDF as:

Size: px
Start display at page:

Download "Epidemiology: Prevalence"

Transcription

1

2 Epidemiology: Prevalence More than 30 million Americans suffer from varicose veins or a more serious form of venous disease called Chronic Venous Insufficiency (CVI). 1 Of the over 30 million Americans affected: Only 1.9 million seek treatment annually 1,2 While the vast majority remain undiagnosed and untreated CVI Prevalence *,1,2 30,000,000+ Seek Treatment *2 1,900,000 Treated 447,0002 (Table 30) *Statistics based on individuals over the age of Gloviczki P, et al. The care of patients with varicose veins and associated chronic diseases: clinical practice guidelines of the Society for Vascular Surgery and the American Venous Forum. JVS; May Lee, A. US markets for varicose vein treatment devices Millennium Research Group, Inc. (A Decision Resource, Inc. Company), May 2011.

3 Prevalence and Etiology of Venous Insufficiency Venous reflux disease is 2x more prevalent than coronary heart disease (CHD) and 5x more prevalent than peripheral arterial disease (PAD) 1 Venous Reflux Disease Coronary Heart Disease Peripheral Arterial Disease Congestive Heart Failure Stroke Cardiac Arrhythmias Heart Valve Disease Brand FN, Dannenberg AL, Abbott RD, Kannel WB. The epidemiology of varicose veins: the Framingham Study. Am J Prev Med 1988; 4(2):96-101

4 Possible Risk Factors and Symptoms of Venous Insufficiency Possible risk factors for venous insufficiency: Gender Age Heredity Pregnancy Standing occupation Obesity Prior injury or surgery Obstruction Symptoms of venous insufficiency: Leg pain, aching, or cramping Burning or itching of the skin Leg or ankle swelling Heavy feeling in legs Skin discoloration or texture changes Open wounds or sores Restless legs Varicose Veins

5 Etiology & Pathophysiology: CEAP C 0 : Asymptomatic. No visible or palpable signs of venous disease C 1 : Spider veins, reticular veins, telangiectasias C 6 : Open Skin Ulcers C 5 : Healed Skin Ulcers C 4 : Pigmentation, Lipodermatosclerosis C 3 : Edema C 2 : Varicose Veins Increased Pain and Reduced Quality of Life Photos courtesy of Rajabrata Sarkar, MD PhD

6

7

8

9 Venous return to right side of heart accomplished thru the actions of the calf muscle pump and venous valves.

10

11

12 Patient Assessment & Diagnosis Patient Assessment Ultrasound Diagnostic Study

13

14

15

16

17 Most commonly used for tributaries and reticular veins. Sodium tetradecyl sulfate, polidocanol, and hypertonic saline most commonly used agents Endothelial damage the result of either osmotic action or protein denaturation

18

19 Percentage of patients treated with the 1.0% polidocanol solution experienced the following mild to moderate adverse events: Closure Rate Reported pain Experienced retained coagulum (blood trapped in varicosities) 15.5% 27.6% 86.20% Experienced a DVT 8.6% Duration 8 Weeks CFVTE 6.9% Todd KL 3rd, et. al. The VANISH-2 study: a randomized, blinded, multicenter study to evaluate the efficacy and safety of polidocanol endovenous microfoam 0.5% and 1.0% compared with placebo for the treatment of incompetence. Phlebology; 2013 Jul 17

20 Duplex ultrasound response at 8 weeks: Placebo PEM 0.125% PEM 0.5% PEM 1.0% Duplex responders 1.8% 59.6% 83.3% % 2 The most commonly reported adverse events in %: Placebo PEM 0.125% PEM 0.5% PEM 1.0% Pain in extremity 10.5% 12.3% 5.0% 15.5% Retained coagulum % 11.7% 27.6% Thrombophlebitis superficial 1.8% 7.0% 13.3% 3.4% Deep vein thrombosis % CFVTE % 3.3% 6.9% Tenderness % 6.9% 1 P < P < compared to PEM 0.125% 3 CFVTE Common Femoral Vein Thrombus Extension. This is non-occlusive thrombi starting in the superficial vein and extending into the common femoral vein (similar to EHIT). Todd KL 3rd, et. al. The VANISH-2 study: a randomized, blinded, multicenter study to evaluate the efficacy and safety of polidocanol endovenous microfoam 0.5% and 1.0% compared with placebo for the treatment of incompetence. Phlebology; 2013 Jul 17

21 Belcaro, G, Nicolaides, AN, Ricci, A, et al. Endovascular sclerotherapy, surgery, and surgery plus sclerotherapy in superficial venous incompetence: a randomized, 10-year follow-up trial--final results. Angiology 2000; 51:529.

22

23 Tumescent needle Injection sites

24 The Venefit Procedure Using the ClosureFast Catheter Minimally invasive treatment option for patients with varicose veins and CVI Controlled and consistent radiofrequency (RF) energy to the ClosureFast catheter The catheter heats the vein wall and contracts the vein wall collagen, thereby occluding the vein

25

26 Proebstle Study 1,2 Multi-center 326 patients 99.6% occlusion at 6 months 90.0% occlusion at 5 years vs VANISH 2 Study 3 Multi-center 232 patients 87.9% occlusion at 8 weeks No data at 5 years 1 Dietzek A. RF Segmental ablation: 5-year data. Annual Symposium on Vascular and Endovascular Issues, Techniques, Horizons (Veith Symposium) New York City; November 19, Proebstle et al. Three-year European follow-up of endovenous radiofrequency-powered segmental thermal ablation of the great saphenous vein with or without treatement of calf varicosities. Journal of Vascular Surgery; Todd KL 3rd, et. al. The VANISH-2 study: a randomized, blinded, multicenter study to evaluate the efficacy and safety of polidocanol endovenous microfoam 0.5% and 1.0% compared with placebo for the treatment of incompetence. Phlebology; 2013 Jul 17 *ClosureFast long-term data is shown for perspective only and not meant to imply that the data can be used in a head-to-head comparison with the data from the Vanish 2 study.

27

28 ClariVein TM *

29 Closure Rate 96.70% Duration 260 days Elias and Raines Mechanochemical Tumescentless Endovenous Ablation: Final Results of the Initial Clinical Trial. Phlebology 2012;27:67-72

30 Proebstle Study 1,2 Multi-center 396 limbs (326 patients) 99.6% occlusion at 6 months 90.0% occlusion at 5 years vs Elias Study 3 Single-center 30 limbs (29 patients) 96.7% occlusion at 260 days No data at 5 years 1 Dietzek A. RF Segmental ablation: 5-year data. Annual Symposium on Vascular and Endovascular Issues, Techniques, Horizons (Veith Symposium) New York City; November 19, Proebstle et al. Three-year European follow-up of endovenous radiofrequency-powered segmental thermal ablation of the great saphenous vein with or without treatement of calf varicosities. Journal of Vascular Surgery; Elias and Raines Mechanochemical Tumescentless Endovenous Ablation: Final Results of the Initial Clinical Trial. Phlebology 2012;27:67-72 *ClosureFast long-term data is shown for perspective only and not meant to imply that the data can be used in a head-to-head comparison with the data from the Elias study.

31 Percent Occlusion 102.0% 100.0% 98.0% 96.0% 94.0% 92.0% 90.0% 88.0% 86.0% 84.0% 99.7% 87.9% 2-8 Weeks 98.6% 96.7% 3-6 Months 95.2% 94.2% 83.7% 90.0% 1 Year 5 Years Rasmussen et al. Randomized clinical trial comparing endovenous laser ablation, radiofrequency ablation, foam sclerotherapy and surgical stripping for great saphenous varicose veins. BJS 2011;98: Elias and Raines Mechanochemical Tumescentless Endovenous Ablation: Final Results of the Initial Clinical Trial. Phlebology 2012;27:67-72 Dietzek A. RF Segmental ablation: 5-year data. Annual Symposium on Vascular and Endovascular Issues, Techniques, Horizons (Veith Symposium) New York City; November 19, 2013 Todd KL 3rd, et. al. The VANISH-2 study: a randomized, blinded, multicenter study to evaluate the efficacy and safety of polidocanol endovenous microfoam 0.5% and 1.0% compared with placebo for the treatment of incompetence. Phlebology; 2013 Jul 17 CLF EVLA MOCA UGFS

32 But is there an even better option to treat cvi?

33 Venaseal Procedure: Non-tumescent, nonthermal, Nonsclerosant

34 FDA Cleared Cyanoacrylate Adhesives (not mutagenic, pyrogenic, hemolytic, sensitizing, irritating or cytotoxic) 2 Adhesive Date Use Cyanoacrylate (CA) Adhesives 1950s Wound adhesives Histoacryl Blue * 1980s Skin incisions Dermabond * 1998 Skin incisions/lacerations Ethicon OMNEX * 1998 Surgical adhesive Trufill * 2000 Liquid embolic system (AVM applications) Indermil * 2002 Skin incisions/lacerations 1 Pollak J, White R. The use of cyanoacrylate adhesives in peripheral embolization. J Vasc Interv Radiol 2001; 12: p Lawson J. et.al. Sapheon: the solution? Phlebology 2013;28Suppl1:2-9 Review article page 3 *Trademark of its respective owner.

35 Widely used medical tissue adhesive. 1 Antimicrobial effect against grampositive organisms. 2 Used safely on millions of patients with no reported carcinogenicity in humans (1986 study). 2 1 Lawson et al. Sapheon: the solution? Phlebology 2013, 28 Suppl 1:2-9, p3 2 Quinn J., Tissue Adhesives in Clinical Medicine, 2nd ed.(2005) p 34-35

36 Properties of Ideal Cyanoacrylate for Venous Closure Ideal viscosity Polymerize quickly Soft and elastic Maintains a strong bond Eliminate need for compression stockings* *Some patients may benefit from compression stockings post procedure.

37 When cyanoacrylate (CA) comes in contact with blood or plasma, it begins to polymerize. The body encapsulates the polymer as a foreign body. CA triggers inflammatory reaction in the vessel wall resulting in occlusion. Almeida J. et.al. Cyanoacrylate adhesive for the closure of truncal veins: 60 day swine model results. Vasc and Endovasc Surg (2011) 000(00) 1-5. DOI / p.1

38 Features of the VenaSeal Procedure Procedure Features Eliminates need for tumescent anesthesia. No risk of thermal injury. No post treatment compression stockings needed. 1,2 * Rapid return to normal activities. 2 1 Almeida, J et al., Two-year follow-up of first human use of cyanoacrylate adhesive for treatment of saphenous vein incompetence. Phlebology / Venous Forum of the Royal Society of Medicine Gibson, K. A Randomized, controlled study comparing cyanoacrylate adhesive embolization with radiofrequency ablation for treatment of incompetent great saphenous veins VeClose study. German Society of Phlebology, *Some patients may benefit from compression stockings post procedure.

39 Feasibility Study 1 escope 2 (European multicenter study) VeClose 3 (U.S. pivotal trial) 38 Patients, enrollment completed Aug , 3, 6, 12, 24 and 36 month follow-ups Primary endpoints: safety and efficacy 70 patients, enrollment completed Sept day, 1, 3, 6, 12, 24 and 36 month follow-ups Primary endpoint: closure w/o use of sedation, tumescent anesthesia or compression stockings 242 Patients, enrollment completed Sept day,1,3,6,12 months and 2,3 year follow-ups Primary endpoint: non-inferior to RFA in GSV closure Secondary endpoint: superiority in reduction of post procedural pain and bruising 1 Almeida, J et al., Two-year follow-up of first human use of cyanoacrylate adhesive for treatment of saphenous vein incompetence. Phlebology / Venous Forum of the Royal Society of Medicine Proebstle, T et al., The european multicenter cohort study on cyanoacrylate embolization of refluxing great saphenous veins. JVS: Venous and Lymphatic Disorders 2014; Accepted for publication. 3 Gibson, K. A Randomized, controlled study comparing cyanoacrylate adhesive embolization with radiofrequency ablation for treatment of incompetent great saphenous veins VeClose study. German Society of Phlebology, 2014.

40 Study Design Endpoints Closure Rates 1 Prospective, non-randomized single center study. To evaluate safety, efficacy and performance of the VenaSeal closure system for the treatment of incompetent saphenous veins. 38 patients enrolled. Safety: Rate of serious adverse events. Efficacy: Treatment success defined as complete occlusion of the treated vein segment using duplex ultrasound imaging. 1-Year: 92% 2-Year: 92% 3-Year: 92% 1 No adjunctive treatments for 6 months Almeida, J et al., Two-year follow-up of first human use of cyanoacrylate adhesive for treatment of saphenous vein incompetence. Phlebology / Venous Forum of the Royal Society of Medicine 2014.

41 Study Design Endpoints Prospective, non-randomized, multicenter study. To evaluate safety, efficacy of the VenaSeal closure system for the treatment of refluxing great saphenous veins. 70 patients enrolled. Follow-up assessments at 48 hours, 1, 3, 6, and 12 months. Duplex ultrasound closure without use of sedation, tumescent anesthesia or compression stockings. Closure Rates 1 6-Months: 94.3% 1-Year: 92.9% 1 No adjunctive treatments for 3 months Proebstle, T et al., The European Multicenter Cohort Study on Cyanoacrylate Embolization of Refluxing Great Saphenous Veins. JVS: Venous and Lymphatic Disorders 2014

42 Study Design Prospective, randomized 1:1 comparing the VenaSeal system (VSCS) to RFA (ClosureFast catheter). Purpose Demonstrate safety and effectiveness of the VenaSeal closure system (VSCS) for the treatment of lower extremity truncal reflux by showing non-inferiority at three months to RFA using the ClosureFast system. Closure Rates 1 3-Months: RFA: 94.3% VSCS: 98.9% 6-Months: RFA: 94.3% VSCS: 98.9% 1 No adjunctive treatments for 3 months Gibson, K. A Randomized, Controlled Study Comparing Cyanoacrylate Adhesive Embolization With Radiofrequency Ablation For Treatment Of Incompetent Great Saphenous Veins VeClose Study. German Society of Phlebology, 2014.

43

Randomized trial comparing cyanoacrylate embolization and radiofrequency ablation for incompetent great saphenous vein

Randomized trial comparing cyanoacrylate embolization and radiofrequency ablation for incompetent great saphenous vein Randomized trial comparing cyanoacrylate embolization and radiofrequency ablation for incompetent great saphenous vein Raghu Kolluri, MD, Director Vascular Medicine OhioHealth Riverside Methodist Hospital

More information

6/1/2017. Mechanico-Chemical Ablation MOCA? Disclaimer

6/1/2017. Mechanico-Chemical Ablation MOCA? Disclaimer Cox Health Venous Symposium June 2-3, 207 Mechanico-Chemical Ablation Non-thermal, Non-tumescent Venous Ablation Therapy ROBERT W. VORHIES, M.D., F.A.C.S. VASCULAR AND ENDOVASCULAR SURGERY ENDOVENOUS THERAPY

More information

Understanding venous disease and treatment options for your patients. Christopher Wulff, MD

Understanding venous disease and treatment options for your patients. Christopher Wulff, MD Understanding venous disease and treatment options for your patients Christopher Wulff, MD Understanding Chronic venous insufficiency (CVI) Important Statistics About CVI Affects all age groups 1 Is ten

More information

Management of Superficial Reflux: Which option, when? Kathleen Gibson, MD Lake Washington Vascular Surgeons Bellevue, WA

Management of Superficial Reflux: Which option, when? Kathleen Gibson, MD Lake Washington Vascular Surgeons Bellevue, WA Management of Superficial Reflux: Which option, when? Kathleen Gibson, MD Lake Washington Vascular Surgeons Bellevue, WA DISCLOSURES Kathleen Gibson, MD Consultant/Advisory Board: BTG, Medtronic Speakers

More information

UNDERSTANDING VEIN DISEASE. UC EN - For use in the U.S. only

UNDERSTANDING VEIN DISEASE. UC EN - For use in the U.S. only UNDERSTANDING VEIN DISEASE UC201706537 EN - For use in the U.S. only Do you need to sit down during your work day because your legs ache and/or swell? Do you miss out on doing the activities you love because

More information

Chronic Venous Insufficiency Compression and Beyond

Chronic Venous Insufficiency Compression and Beyond Disclosure of Conflict of Interest Chronic Venous Insufficiency Compression and Beyond Shawn Amyot, MD, CCFP Fellow of the Canadian Society of Phlebology Ottawa Vein Centre I do not have relevant financial

More information

The Vascular Disease Almost No One Teaches But Should!!! Chronic Venous Insufficiency

The Vascular Disease Almost No One Teaches But Should!!! Chronic Venous Insufficiency The Vascular Disease Almost No One Teaches But Should!!! Chronic Venous Insufficiency Thomas E. Eidson, DO Certified Venous Disease Specialist Board Certified Family Medicine Disclosure of Conflict of

More information

MOCA and GLUE: results and analyses of the RCTs

MOCA and GLUE: results and analyses of the RCTs MOCA and GLUE: results and analyses of the RCTs Faculty disclosure Research Grant Medtronic Educational Grant mediusa Speakers Bureau Medtronic Pierre Fabre mediusa Medical Director Morrison Vein/Training

More information

Additional Information S-55

Additional Information S-55 Additional Information S-55 Network providers are encouraged, but not required to participate in the on-line American Venous Forum Registry (AVR) - The First National Registry for the Treatment of Varicose

More information

Why Tumescent-Free Therapy Will Replace RF and Laser

Why Tumescent-Free Therapy Will Replace RF and Laser C SCOTT MCENROE Medical Director Vein Center of Virginia Sentara Medical Group April 27, 2018 Why Tumescent-Free Therapy Will Replace RF and Laser History of Venous Surgery 1950 s GSV/SSV stripping became

More information

SAVE LIMBS SAVE LIVES! Endovenous Ablation for Chronic Wounds

SAVE LIMBS SAVE LIVES! Endovenous Ablation for Chronic Wounds SAVE LIMBS SAVE LIVES! Endovenous Ablation for Chronic Wounds Frank J. Tursi, DPM, FACFS Clinical Associate Professor, University of Pennsylvania/Presbyterian Foot and Ankle Consultant, Philadelphia Flyers,

More information

Venous Disease and Leg Ulcers. Edward G Mackay MD St. Petersburg, FL NCVH 2015 Orlando, FL

Venous Disease and Leg Ulcers. Edward G Mackay MD St. Petersburg, FL NCVH 2015 Orlando, FL Venous Disease and Leg Ulcers Edward G Mackay MD St. Petersburg, FL NCVH 2015 Orlando, FL Disclosures Stocks Endoshape Sapheon Medical Advisory Board BTG, Boston Scientific Venous Leg Ulcer Most common

More information

Conflict of Interest. None

Conflict of Interest. None Conflict of Interest None American Venous Forum Guidelines on Superficial Venous Disease TOP 10 GUIDELINES 10. We recommend using the CEAP classification to describe chronic venous disorders. (GRADE 1B)

More information

Chronic Venous Insufficiency

Chronic Venous Insufficiency Chronic Venous Insufficiency None Disclosures Lesley Enfinger, MSN,NP-C Chronic Venous Insufficiency Over 24 Million Americans affected by Chronic Venous Insufficiency (CVI) 10 x More Americans suffer

More information

New Technologies in Superficial Vein Treatment

New Technologies in Superficial Vein Treatment New Technologies in Superficial Vein Treatment Ariel D. Soffer, MD, FACC Associate Clinical Professor Florida International University Medical School Ariel Soffer, MD, FACC Bio Fellow of the American College

More information

Criteria For Medicare Members. Kaiser Foundation Health Plan of Washington

Criteria For Medicare Members. Kaiser Foundation Health Plan of Washington Clinical Review Criteria Treatment of Varicose Veins Radiofrequency Catheter Closure Sclerotherapy Surgical Stripping Trivex System for Outpatient Varicose Vein Surgery VenaSeal Closure System VNUS Closure

More information

Current Management of Varicose Veins

Current Management of Varicose Veins Current Management of Varicose Veins Michael J. Heidenreich, MD St. Joseph Mercy Hospital Ann Arbor, MI March 23, 2013 Nothing to disclose History Prevalence Anatomy Risk factors Clinical manifestations

More information

FIND RELIEF FROM VARICOSE VEINS. VenaSeal Sapheon Closure System

FIND RELIEF FROM VARICOSE VEINS. VenaSeal Sapheon Closure System FIND RELIEF FROM VARICOSE VEINS VenaSeal Sapheon Closure System UNDERSTAND Varicose veins may be a sign of something more severe. Your doctor can help you understand if you have this condition. may cause

More information

A treatment option for varicose veins. enefit" Targeted Endovenous Therapy. Formerly known as the VNUS Closure procedure E 3 COVIDIEN

A treatment option for varicose veins. enefit Targeted Endovenous Therapy. Formerly known as the VNUS Closure procedure E 3 COVIDIEN A treatment option for varicose veins. enefit" Targeted Endovenous Therapy Formerly known as the VNUS Closure procedure E 3 COVIDIEN THE VENOUS SYSTEM ANATOMY The venous system is made up of a network

More information

FIND RELIEF FROM VARICOSE VEINS. VenaSeal Closure System

FIND RELIEF FROM VARICOSE VEINS. VenaSeal Closure System FIND RELIEF FROM VARICOSE VEINS VenaSeal Closure System UNDERSTAND Varicose veins may be a sign of something more severe venous reflux disease Your doctor can help you understand if you have this condition.

More information

Closurefast radiofrequency ablation for the treatment of GSV: Technique and outcome results

Closurefast radiofrequency ablation for the treatment of GSV: Technique and outcome results Closurefast radiofrequency ablation for the treatment of GSV: Technique and outcome results Stephen Black Consultant Vascular Surgeon Clinical Lead for Venous and Lymphoedema Surgery Guy s and St Thomas

More information

Thermal Techniques: Outcomes and Complications

Thermal Techniques: Outcomes and Complications Thermal Techniques: Outcomes and Complications Meet The Experts: Thermal and Non-Thermal Ablation Techniques Joseph D. Raffetto MD VA Boston HCS, West Roxbury, MA, Harvard Medical School, Boston, MA; Brigham

More information

Find From Varicose Veins. VenaSeal

Find From Varicose Veins. VenaSeal Find Relief From Varicose Veins VenaSeal Closure System Understand Varicose veins may be a sign of something more severe venous reflux disease. Your doctor can help you understand if you have this condition.

More information

RECOGNITION AND ENDOVASCULAR TREATMENT OF CHRONIC VENOUS INSUFFICIENCY

RECOGNITION AND ENDOVASCULAR TREATMENT OF CHRONIC VENOUS INSUFFICIENCY RECOGNITION AND ENDOVASCULAR TREATMENT OF CHRONIC VENOUS INSUFFICIENCY Paul Kramer, MD, FACC, FSCAI Liberty Cardiovascular Specialists Liberty Regional Heart and Vascular Center DISCLOSURES NONE Venous

More information

OHTAC Recommendation. Endovascular Laser Treatment for Varicose Veins. Presented to the Ontario Health Technology Advisory Committee in November 2009

OHTAC Recommendation. Endovascular Laser Treatment for Varicose Veins. Presented to the Ontario Health Technology Advisory Committee in November 2009 OHTAC Recommendation Endovascular Laser Treatment for Varicose Veins Presented to the Ontario Health Technology Advisory Committee in November 2009 April 2010 Issue Background The Ontario Health Technology

More information

Perforators: When to Treat and How Best to Do It? Eric Hager, MD September 10, 2015

Perforators: When to Treat and How Best to Do It? Eric Hager, MD September 10, 2015 Perforators: When to Treat and How Best to Do It? Eric Hager, MD September 10, 2015 Anatomy of Perforating veins Cadaveric studies 1 have shown >60 vein perforating veins from superficial to deep Normal

More information

TREATMENT OPTIONS FOR CHRONIC VENOUS INSUFFICIENCY

TREATMENT OPTIONS FOR CHRONIC VENOUS INSUFFICIENCY TREATMENT OPTIONS FOR CHRONIC VENOUS INSUFFICIENCY TL LUK Consultant Vascular Surgeon Sarawak General Hospital HKL Vascular Conference 19/06/2013 PREVALENCE OF LOWER LIMB VENOUS DISEASE Affects half of

More information

Endovenous Thermal vs. Endovenous Chemical Ablation What is the Best for the Patient

Endovenous Thermal vs. Endovenous Chemical Ablation What is the Best for the Patient Endovenous Thermal vs. Endovenous Chemical Ablation What is the Best for the Patient T. Noppeney, J. Noppeney Center for Vascular Diseases: Outpatient Dept. Obere Turnstrasse, Dept. for Vascular Surgery

More information

New Guideline in venous ulcer treatment: dressing, medication, intervention

New Guideline in venous ulcer treatment: dressing, medication, intervention New Guideline in venous ulcer treatment: dressing, medication, intervention Kittipan Rerkasem, FRCS(T), PhD Department of Surgery Faculty of Medicine Chiang Mai University Topic Overview venous ulcer treatment

More information

RADIOFREQUENCY ABLATION. Drs PIRET V, BERGERON P MEET CANNES 2009

RADIOFREQUENCY ABLATION. Drs PIRET V, BERGERON P MEET CANNES 2009 RADIOFREQUENCY ABLATION Drs PIRET V, BERGERON P MEET CANNES 2009 Superficial Venous Disease: EPIDEMIOLOGY Touch 75% of french population at different degrees (45.10 6 ) 25% needs medical care (11.10 6

More information

Medical Policy. Description/Scope. Position Statement

Medical Policy. Description/Scope. Position Statement Subject: Document #: Publish Date: 12/27/2017 Status: Revised Last Review Date: 05/04/2017 Description/Scope This document addresses various modalities (listed below) for the treatment of valvular incompetence

More information

Patient Information. Venous Insufficiency and Varicose Veins

Patient Information. Venous Insufficiency and Varicose Veins Patient Information Venous Insufficiency and Varicose Veins What is a Varicose Vein? Gitter Vein Institute-revised 3/8/2016 2 Frequently Asked Questions What is the difference between varicose and spider

More information

LINC, Christine Teichert, MD University Medicine of Rostock, Dept. of diagnostic and interventional radiology, Germany

LINC, Christine Teichert, MD University Medicine of Rostock, Dept. of diagnostic and interventional radiology, Germany Comparison of the efficacy, safety, the primary and secondary technical success of the endovenous nonthermal, tumescensless mechanochemical ablation of varicose veins with the subjective outcome using

More information

How varicose veins occur

How varicose veins occur Varicose veins are a very common problem, generally appearing as twisting, bulging rope-like cords on the legs, anywhere from groin to ankle. Spider veins are smaller, flatter, red or purple veins closer

More information

Date: A. Venous Health History Form. Patient please complete questions Primary Care Physician:

Date: A. Venous Health History Form. Patient please complete questions Primary Care Physician: E S Insurance: 2 nd Insurance: Wait time: Date: A. Venous Health History Form Patient please complete questions 1-12 Patient Name: SSN#: Date of Birth: Primary Care Physician: What is the reason for your

More information

Priorities Forum Statement

Priorities Forum Statement Priorities Forum Statement Number 9 Subject Varicose Vein Surgery Date of decision September 2014 Date refreshed March 2017 Date of review September 2018 Relevant OPCS codes: L841-46, L848-49, L851-53,

More information

VeClose trial Cyanoacylate closure vs. RF ablation 36-month results

VeClose trial Cyanoacylate closure vs. RF ablation 36-month results VeClose trial Cyanoacylate closure vs. RF ablation 36-month results LINC 2018, Leipzig 31 st Jan 2018 Tobias Hirsch, Halle, Germany www.gefaessmedizin-hirsch.de Disclosure Tobias Hirsch I have the following

More information

Sadie Ahanchi, MD Sentara Vascular Specialists April 27,2018. Debate 1: Why Is Tumescent-Based Therapy The Gold Standard?

Sadie Ahanchi, MD Sentara Vascular Specialists April 27,2018. Debate 1: Why Is Tumescent-Based Therapy The Gold Standard? Sadie Ahanchi, MD Sentara Vascular Specialists April 27,2018 Debate 1: Why Is Tumescent-Based Therapy The Gold Standard? Tumescent based venous therapy: Fight! Introduction Tumescent anesthesia Administration

More information

MEDICAL POLICY SUBJECT: VARICOSITIES, TREATMENT ALTERNATIVES TO VEIN STRIPPING AND LIGATION. POLICY NUMBER: CATEGORY: Technology Assessment

MEDICAL POLICY SUBJECT: VARICOSITIES, TREATMENT ALTERNATIVES TO VEIN STRIPPING AND LIGATION. POLICY NUMBER: CATEGORY: Technology Assessment MEDICAL POLICY PAGE: 1 OF: 9 If the member's subscriber contract excludes coverage for a specific service it is not covered under that contract. In such cases, medical policy criteria are not applied.

More information

Non-Saphenous Vein Treatments. Jessica Ochs PA-C Albert Vein Institute Colorado Springs and Lone Tree, CO

Non-Saphenous Vein Treatments. Jessica Ochs PA-C Albert Vein Institute Colorado Springs and Lone Tree, CO Non-Saphenous Vein Treatments Jessica Ochs PA-C Albert Vein Institute Colorado Springs and Lone Tree, CO I have no financial disclosures Types of Veins Treated Perforator Veins Tributary Veins Varicose

More information

Treatment of Varicose Veins/Venous Insufficiency

Treatment of Varicose Veins/Venous Insufficiency MEDICAL POLICY 7.01.519 Treatment of Varicose Veins/Venous Insufficiency BCBSA Ref. Policy: 7.01.124 Effective Date: March 1, 2017 Last Revised: Jan. 23, 2018 Replaces: 7.01.55, 7.01.76, 7.01.515, and

More information

Are there differences in guidelines for management of CVD between Europe and the US? Bo Eklöf, MD, PhD Lund University Sweden

Are there differences in guidelines for management of CVD between Europe and the US? Bo Eklöf, MD, PhD Lund University Sweden Are there differences in guidelines for management of CVD between Europe and the US? Bo Eklöf, MD, PhD Lund University Sweden Disclosures No disclosures Five sources for comparison SVS/AVF US guidelines

More information

AMERICAN PODIATRIC MEDICAL ASSOCIATION

AMERICAN PODIATRIC MEDICAL ASSOCIATION AMERICAN PODIATRIC MEDICAL ASSOCIATION THE NATIONAL ANNUAL SCIENTIFIC MEETING Friday, July 13 th 2018 Washington, D.C. CHRONIC VENOUS INSUFFICIENCY OF THE LOWER EXTREMITIES Clinical Pearls for the Podiatrist

More information

Cyanoacrylate vs laser ablation. Turkish experience. A. Kursat Bozkurt MD University of Istanbul

Cyanoacrylate vs laser ablation. Turkish experience. A. Kursat Bozkurt MD University of Istanbul Cyanoacrylate vs laser ablation. Turkish experience A. Kursat Bozkurt MD University of Istanbul Disclosure Speaker name: A. Kursat Bozkurt I have the following potential conflicts of interest to report:

More information

lipodermatosclerosis standards of medical practitioners and the quality of patient care related to the treatment of venous disorders.

lipodermatosclerosis standards of medical practitioners and the quality of patient care related to the treatment of venous disorders. Chattanooga s premiere VEIN CENTER Update on Venous Insufficiency, Varicose and Spider Veins 2016 Vincent W. Gardner, MD, FACS, RPVI Fellow, American College of Surgeons Board Certified, American Board

More information

Clinical/Duplex Evaluation of Varicose Veins: Who to Treat?

Clinical/Duplex Evaluation of Varicose Veins: Who to Treat? Clinical/Duplex Evaluation of Varicose Veins: Who to Treat? Sanjoy Kundu MD, FASA, FCIRSE, FSIR The Vein Institute of Toronto Scarborough Vascular Group Scarborough Vascular Ultrasound Scarborough Vascular

More information

Date: A. Venous Health History Form. Patient please complete questions Primary Care Physician:

Date: A. Venous Health History Form. Patient please complete questions Primary Care Physician: E S Insurance: 2 nd Insurance: Wait time: Date: A. Venous Health History Form Patient please complete questions 1-12 Patient Name: SSN#: Date of Birth: Primary Care Physician: What is the reason for your

More information

PROVIDER POLICIES & PROCEDURES

PROVIDER POLICIES & PROCEDURES PROVIDER POLICIES & PROCEDURES TREATMENT OF VARICOSE VEINS OF THE LOWER EXTREMITIES STAB PHLEBECTOMY AND SCLEROTHERAPY TREATMENT The primary purpose of this document is to assist providers enrolled in

More information

Varicose Veins are a Symptom of Vein Disease. Now you can treat the source of your varicose veins with non-surgical endovenous laser treatment.

Varicose Veins are a Symptom of Vein Disease. Now you can treat the source of your varicose veins with non-surgical endovenous laser treatment. Varicose Veins are a Symptom of Vein Disease. Now you can treat the source of your varicose veins with non-surgical endovenous laser treatment. Approximately 1 in 5 adult Americans suffer from superficial

More information

Treatment of Varicose Veins

Treatment of Varicose Veins Treatment of Varicose Veins Policy Number: Original Effective Date: MM.06.016 04/15/2005 Line(s) of Business: Current Effective Date: PPO; HMO; QUEST Integration 09/28/2018 Section: Surgery Place(s) of

More information

Patient assessment and strategy making for endovenous treatment

Patient assessment and strategy making for endovenous treatment Patient assessment and strategy making for endovenous treatment Raghu Kolluri, MD Director Vascular Medicine OhioHealth Riverside Methodist Hospital Columbus, OH Disclosures Current Medtronic Consultant/

More information

Disclosures. What is a Specialty Vein Clinic? Prevalence of Venous Disease. Management of Venous Disease: an evidence based approach.

Disclosures. What is a Specialty Vein Clinic? Prevalence of Venous Disease. Management of Venous Disease: an evidence based approach. Management of Venous Disease: an evidence based approach Disclosures Ed Boyle, MD Andrew Jones, MD Dr. Ed Boyle and Dr. Andrew Jones disclose Grants/research support: Medtronic, BTG International, Clearflow,

More information

Medical Affairs Policy

Medical Affairs Policy Service: Varicose Vein Treatments PUM 250-0032 Medical Affairs Policy Medical Policy Committee Approval 12/01/17 Effective Date 04/01/18 Prior Authorization Needed Yes Disclaimer: This policy is for informational

More information

Medicare C/D Medical Coverage Policy

Medicare C/D Medical Coverage Policy Varicose Vein Treatment Medicare C/D Medical Coverage Policy Origination Date: June 1, 1993 Review Date: February 15, 2017 Next Review: February, 2019 DESCRIPTION OF PROCEDURE OR SERVICE Varicose veins

More information

Which place for liquid sclerotherapy? Eberhard Rabe Department of Dermatology University of Bonn Germany

Which place for liquid sclerotherapy? Eberhard Rabe Department of Dermatology University of Bonn Germany Which place for liquid sclerotherapy? Eberhard Rabe Department of Dermatology University of Bonn Germany Liquid Foam or GSV, foam / liquid sclerosant n diameter[mm] Follow up effectivity Hamel Desnos 2003

More information

RE: Request for coverage and reimbursement for mechano-chemical venous ablation Clarivein

RE: Request for coverage and reimbursement for mechano-chemical venous ablation Clarivein October 7, 2016 Craig Haug, MD JK MAC Medical Director NHIC, Corp. Hewlett Packard Enterprise 75 William Terry Dr., Hingham, MA 02043 Dear Dr. Haug: RE: Request for coverage and reimbursement for mechano-chemical

More information

[Kreussler Studies] FDA. multicenter GCP. controlled. randomized. prospective. blinded SUMMARY OF PIVOTAL STUDIES ON SCLEROTHERAPY OF VARICOSE VEINS

[Kreussler Studies] FDA. multicenter GCP. controlled. randomized. prospective. blinded SUMMARY OF PIVOTAL STUDIES ON SCLEROTHERAPY OF VARICOSE VEINS [Kreussler Studies] SUMMARY OF PIVOTAL STUDIES ON SCLEROTHERAPY OF VARICOSE VEINS FDA randomized controlled GCP blinded prospective multicenter [Sclerotherapy of Varices] Healthy legs with microfoam Chemische

More information

MEDICAL POLICY SUBJECT: VARICOSITIES, TREATMENT ALTERNATIVES TO VEIN STRIPPING AND LIGATION

MEDICAL POLICY SUBJECT: VARICOSITIES, TREATMENT ALTERNATIVES TO VEIN STRIPPING AND LIGATION MEDICAL POLICY SUBJECT: VARICOSITIES, TREATMENT PAGE: 1 OF: 10 If a product excludes coverage for a service, it is not covered, and medical policy criteria do not apply. If a commercial product, including

More information

Treatment of Varicose Veins/Venous Insufficiency

Treatment of Varicose Veins/Venous Insufficiency Applies to all products administered or underwritten by Blue Cross and Blue Shield of Louisiana and its subsidiary, HMO Louisiana, Inc.(collectively referred to as the Company ), unless otherwise provided

More information

Vein Disease Treatment

Vein Disease Treatment MP9241 Covered Service: Yes when meets criteria below Prior Authorization Required: Yes as indicated in 2.0, 3.0, 4.0 and 5.0 Additional Information: None Prevea360 Health Plan Medical Policy: Vein disease

More information

Varicose Veins What Are They? Sclerotherapy in the Treatment of Venous Disease Zachary C. Schmittling, MD, FACS May 4, 2018

Varicose Veins What Are They? Sclerotherapy in the Treatment of Venous Disease Zachary C. Schmittling, MD, FACS May 4, 2018 Sclerotherapy in the Treatment of Venous Disease Zachary C. Schmittling, MD, FACS May 4, 2018 Sclerotherapy for Venous Disease: Overview 1 in 5 Americans Approximately 25% of women have some type of lower

More information

How to choose which treatment method(s) to use for a particular varicose veins patient ESTABLISHING A TREATMENT PLAN.

How to choose which treatment method(s) to use for a particular varicose veins patient ESTABLISHING A TREATMENT PLAN. How to choose which treatment method(s) to use for a particular varicose veins patient ESTABLISHING A TREATMENT PLAN Surgeon Dr G Mark Malouf Sydney Australia Following History and Physical examination

More information

Varicose veins. Natural history, assessment and management. Arteries and veins. Why do people get varicose veins? Classification of venous disease

Varicose veins. Natural history, assessment and management. Arteries and veins. Why do people get varicose veins? Classification of venous disease Arteries and veins Neil Wright Rob Fitridge Varicose veins Natural history, assessment and management Background Varicose veins are a common condition. Presentations can range from those that are noticed

More information

Endothermal Ablation for Venous Insufficiency. Dr. S. Kundu Medical Director The Vein Institute of Toronto

Endothermal Ablation for Venous Insufficiency. Dr. S. Kundu Medical Director The Vein Institute of Toronto Endothermal Ablation for Venous Insufficiency Dr. S. Kundu Medical Director The Vein Institute of Toronto Objective: remove the GSV from the circulation 1. Surgical - HL & stripping 2. Chemical sclerotherapy

More information

venous insufficiency remains the most prevalent

venous insufficiency remains the most prevalent Venous Insufficiency: The Changing Paradigm in Vascular Disease Robert Coronado, MD From Northern Heart & Vascular Institute Inc., Redding, California. ABSTRACT: Venous insufficiency is the most common

More information

MEDICAL POLICY SUBJECT: VARICOSITIES, TREATMENT ALTERNATIVES TO VEIN STRIPPING AND LIGATION

MEDICAL POLICY SUBJECT: VARICOSITIES, TREATMENT ALTERNATIVES TO VEIN STRIPPING AND LIGATION MEDICAL POLICY SUBJECT: VARICOSITIES, TREATMENT PAGE: 1 OF: 12 If a product excludes coverage for a service, it is not covered, and medical policy criteria do not apply. If a commercial product, including

More information

Treatment of Varicose Veins/Venous Insufficiency. Description

Treatment of Varicose Veins/Venous Insufficiency. Description Page: 1 of 24 Last Review Status/Date: March 2015 Description A variety of treatment modalities are available to treat varicose veins/venous insufficiency, including surgical approaches, thermal ablation,

More information

UNDERSTANDING VEIN PROBLEMS

UNDERSTANDING VEIN PROBLEMS UNDERSTANDING VEIN PROBLEMS Varicose Veins, Chronic Venous Insufficiency, and DVT Do You Have a Vein Problem? Have you noticed pain or swelling in your legs? Do your symptoms worsen when you re sitting

More information

Subject: Treatments for Varicose Veins/Venous Insufficiency

Subject: Treatments for Varicose Veins/Venous Insufficiency 02-33000-31 Original Effective Date: 02/15/02 Reviewed: 08/23/18 Revised: 09/15/18 Subject: Treatments for Varicose Veins/Venous Insufficiency THIS MEDICAL COVERAGE GUIDELINE IS NOT AN AUTHORIZATION, CERTIFICATION,

More information

VeClose trial 12-month outcomes of cyanoacrylate closure versus radiofrequency ablation for incompetent great saphenous veins

VeClose trial 12-month outcomes of cyanoacrylate closure versus radiofrequency ablation for incompetent great saphenous veins VeClose trial 12-month outcomes of cyanoacrylate closure versus radiofrequency ablation for incompetent great saphenous veins Nick Morrison, MD, a Kathleen Gibson, MD, b Michael Vasquez, MD, c Robert Weiss,

More information

Medical Policy An independent licensee of the Blue Cross Blue Shield Association

Medical Policy An independent licensee of the Blue Cross Blue Shield Association Varicose Veins Page 1 of 37 Medical Policy An independent licensee of the Blue Cross Blue Shield Association Title: Varicose Veins Professional Institutional Original Effective Date: January 1, 2004 Original

More information

SAFETY AND FEASIBILITY OF MECHANO-CHEMICAL ABLATION OF VARICOSE VEINS: INITIAL RESULTS

SAFETY AND FEASIBILITY OF MECHANO-CHEMICAL ABLATION OF VARICOSE VEINS: INITIAL RESULTS SAFETY AND FEASIBILITY OF MECHANO-CHEMICAL ABLATION OF VARICOSE VEINS: INITIAL RESULTS Michel M.P.J. Reijnen, M.D., Ph.D. Jean-Paul P.M. de Vries, M.D., Ph.D. Rijnstate Hospital, Arnhem, The Netherlands

More information

Endo-Thermal Heat Induced Thrombosis (E-HIT)

Endo-Thermal Heat Induced Thrombosis (E-HIT) Endo-Thermal Heat Induced Thrombosis (E-HIT) Michael Ombrellino MD FACS The Cardiovascular Care Group Clinical Associate Professor of Surgery Rutgers School of Medicine Objectives: What is E-HIT? How do

More information

Kathleen Gibson, MD. Lake Washington Vascular Surgeons Bellevue, WA

Kathleen Gibson, MD. Lake Washington Vascular Surgeons Bellevue, WA Cyanoacrylate Closure of Incompetent Great, Small and Accessory Saphenous Veins without the use of Post-Procedure Compression: a Post-Market Evaluation of the VenaSeal System (WAVES trial): Three Month

More information

Varicose Vein Information Sheet

Varicose Vein Information Sheet Neil Goldstein, MD Joseph Hewett, MD Board- Certified Physicians in Interventional, Diagnostic, and Vascular Radiology, Surgery, Vascular Surgery and Phlebology Varicose Vein Information Sheet PREVALENCE

More information

POLICY PRODUCT VARIATIONS DESCRIPTION/BACKGROUND RATIONALE DEFINITIONS BENEFIT VARIATIONS DISCLAIMER CODING INFORMATION REFERENCES POLICY HISTORY

POLICY PRODUCT VARIATIONS DESCRIPTION/BACKGROUND RATIONALE DEFINITIONS BENEFIT VARIATIONS DISCLAIMER CODING INFORMATION REFERENCES POLICY HISTORY Original Issue Date (Created): July 12, 2003 Most Recent Review Date (Revised): May 20, 2014 Effective Date: October 1, 2014 POLICY PRODUCT VARIATIONS DESCRIPTION/BACKGROUND RATIONALE DEFINITIONS BENEFIT

More information

SURGICAL AND ABLATIVE PROCEDURES FOR VENOUS INSUFFICIENCY AND VARICOSE VEINS

SURGICAL AND ABLATIVE PROCEDURES FOR VENOUS INSUFFICIENCY AND VARICOSE VEINS UnitedHealthcare Commercial Medical Policy SURGICAL AND ABLATIVE PROCEDURES FOR VENOUS INSUFFICIENCY AND VARICOSE VEINS Policy Number: 2018T0447V Effective Date: March 1, 2018 Table of Contents Page INSTRUCTIONS

More information

Corporate Medical Policy

Corporate Medical Policy Corporate Medical Policy Varicose Veins of the Lower Extremities, Treatment for File Name: Origination: Last CAP Review: Next CAP Review: Last Review: varicose_veins_of_the_lower_extremities_treatment_for

More information

Surgery or combined endolaser ablation and sclerotherapy for varicose veins, a new trend in a developing country (Iraq); a cohort study

Surgery or combined endolaser ablation and sclerotherapy for varicose veins, a new trend in a developing country (Iraq); a cohort study Surgery or combined endolaser ablation and sclerotherapy for varicose veins, a new trend in a developing country (Iraq); a cohort study Bashar Hanna Azar (1) Ashur Yohanna Izac Oraha (2) Emad Abdulrahman

More information

SURGICAL AND ABLATIVE PROCEDURES FOR VENOUS INSUFFICIENCY AND VARICOSE VEINS

SURGICAL AND ABLATIVE PROCEDURES FOR VENOUS INSUFFICIENCY AND VARICOSE VEINS UnitedHealthcare Community Plan Medical Policy SURGICAL AND ABLATIVE PROCEDURES FOR VENOUS INSUFFICIENCY AND VARICOSE VEINS Policy Number: CS117.N Effective Date: April 1, 2019 Instructions for Use Table

More information

DISORDERS OF VENOUS SYSTEM

DISORDERS OF VENOUS SYSTEM DISORDERS OF VENOUS SYSTEM Varicose Veins Any dilated, elongated and tortuous vein irrespective of size Varicose veins are common in the superficial veins of the leg which are subject to high pressure

More information

Treatment of Varicose Veins/Venous Insufficiency Corporate Medical Policy

Treatment of Varicose Veins/Venous Insufficiency Corporate Medical Policy Treatment of Varicose Veins/Venous Insufficiency Corporate Medical Policy File name: Treatment of Varicose Veins/Venous Insufficiency File code: UM.SURG.03 Origination: 9/01/2010 Last Review: 03/2015 Next

More information

Treatment of Venous ulcers utilizing n-butyl Cyanoacrylate (Super Glue)

Treatment of Venous ulcers utilizing n-butyl Cyanoacrylate (Super Glue) Treatment of Venous ulcers utilizing n-butyl Cyanoacrylate (Super Glue) Awais Siddique MD Endovascular Radiologist AZH WAVE CENTERS Milwaukee WI Venous disease Etiology Are the result of Venous valvular

More information

Patients with varicose veins (VV)

Patients with varicose veins (VV) Jerry C. Chen, MD, FRCSC Current therapy for primary varicose veins Assessment and treatment options for patients with varicose veins have improved with the availability of office-based ultrasound and

More information

PHLEBOLOGY. Venous Insufficiency. Presentation Use Information

PHLEBOLOGY. Venous Insufficiency. Presentation Use Information Disclosure of Conflict of Interest THE BASICS OF VENOUS INSUFFICIENCY: What You Should Know. An Introductory Lecture Donald Ives, MD, RVT, RPVI Board Certified Family Physician Diplomate of the American

More information

SURGICAL AND ABLATIVE PROCEDURES FOR VENOUS INSUFFICIENCY AND VARICOSE VEINS

SURGICAL AND ABLATIVE PROCEDURES FOR VENOUS INSUFFICIENCY AND VARICOSE VEINS UnitedHealthcare Commercial Medical Policy SURGICAL AND ABLATIVE PROCEDURES FOR VENOUS INSUFFICIENCY AND VARICOSE VEINS Policy Number: 2017T0447T Effective Date: July 1, 2017 Table of Contents Page INSTRUCTIONS

More information

Love your legs again Varicose Veins

Love your legs again Varicose Veins Love your legs again Varicose Veins Veins are the vessels that return blood to the heart once it has circulated through the body (as opposed to arteries, which carry oxygen-rich blood from the heart to

More information

MedStar Health, Inc. POLICY AND PROCEDURE MANUAL Policy Number: MP.066.MH Last Review Date: 11/08/2018 Effective Date: 01/01/2019

MedStar Health, Inc. POLICY AND PROCEDURE MANUAL Policy Number: MP.066.MH Last Review Date: 11/08/2018 Effective Date: 01/01/2019 MedStar Health, Inc. POLICY AND PROCEDURE MANUAL This policy applies to the following lines of business: MedStar Employee (Select) MedStar CareFirst PPO MedStar Health considers the treatment of Varicose

More information

Clinical case. Symptomatic anterior accessory great saphenous vein (AAGSV) reflux

Clinical case. Symptomatic anterior accessory great saphenous vein (AAGSV) reflux Clinical case Symptomatic anterior accessory great saphenous vein (AAGSV) reflux A 70 year-old female presents with symptomatic varicose veins on left leg for more than 10 years. She complains of heaviness,

More information

SURGICAL AND ABLATIVE PROCEDURES FOR VENOUS INSUFFICIENCY AND VARICOSE VEINS

SURGICAL AND ABLATIVE PROCEDURES FOR VENOUS INSUFFICIENCY AND VARICOSE VEINS UnitedHealthcare Oxford Clinical Policy SURGICAL AND ABLATIVE PROCEDURES FOR VENOUS INSUFFICIENCY AND VARICOSE VEINS Policy Number: OUTPATIENT 013.32 T2 Effective Date: February 1, 2018 Table of Contents

More information

Le varici recidive Recurrent varices: how to manage them?

Le varici recidive Recurrent varices: how to manage them? Le varici recidive Recurrent varices: how to manage them? Marianne De Maeseneer MD PhD, Vascular Surgeon Department of Dermatology, Rotterdam, Netherlands & Faculty of Medicine and Health Sciences University

More information

Determine the patients relative risk of thrombosis. Be confident that you have had a meaningful discussion with the patient.

Determine the patients relative risk of thrombosis. Be confident that you have had a meaningful discussion with the patient. Patient Assessment :Venous History, Examination and Introduction to Doppler and PPG Dr Louis Loizou The 11 th Annual Scientific Meeting and Workshops of the Australasian College of Phlebology Tuesday 18

More information

WHAT ABOUT FOAM SCLEROTHERAPY IN REVAS? Dr O CRETON Ste FOY LES LYON

WHAT ABOUT FOAM SCLEROTHERAPY IN REVAS? Dr O CRETON Ste FOY LES LYON WHAT ABOUT FOAM SCLEROTHERAPY IN REVAS? Dr O CRETON Ste FOY LES LYON Disclosure of Interest I have the following potential conflicts of interest to report: Consulting: Medtronic WHAT ABOUT REVAS? Source

More information

ABLATIVE AND SURGICAL TREATMENT FOR VENOUS INSUFFICIENCY

ABLATIVE AND SURGICAL TREATMENT FOR VENOUS INSUFFICIENCY ABLATIVE AND SURGICAL TREATMENT FOR VENOUS INSUFFICIENCY POLICY Description of Service A variety of treatment modalities are available to treat varicose veins/venous insufficiency, including surgical approaches,

More information

Varithena 3 rd February 2015

Varithena 3 rd February 2015 Varithena 3 rd February 2015 Forward-looking statement This presentation and information communicated verbally to you may contain certain projections and other forward-looking statements with respect to

More information

The Management of Stasis Dermatitis and Chronic Venous Insufficiency in Patients Refractory to Conservative Therapies

The Management of Stasis Dermatitis and Chronic Venous Insufficiency in Patients Refractory to Conservative Therapies Article The Management of Stasis Dermatitis and Chronic Venous Insufficiency in Patients Refractory to Conservative Therapies Kareem Halim, 1,2, * Mark J. McElroy, 1 and John A. Lewis 3 1 Havard Medical

More information

MEDICAL POLICY SUBJECT: VARICOSITIES, TREATMENT ALTERNATIVES TO VEIN STRIPPING AND LIGATION

MEDICAL POLICY SUBJECT: VARICOSITIES, TREATMENT ALTERNATIVES TO VEIN STRIPPING AND LIGATION MEDICAL POLICY SUBJECT: VARICOSITIES, TREATMENT PAGE: 1 OF: 8 If the member's subscriber contract excludes coverage for a specific service it is not covered under that contract. In such cases, medical

More information

o Self-Contained & Disposable: Fully self-contained, single-use device with no need for capital equipment purchase

o Self-Contained & Disposable: Fully self-contained, single-use device with no need for capital equipment purchase The ClariVein OC Proprietary dual action device^ ClariVein OC is a specialty catheter for the infusion of physician-specified agents in the peripheral vasculature including for endovascular occlusion of

More information