Techniques and Specific Treatment Modalities for the Active Non-Healing Wound. Luke Maj, MD, MHA
|
|
- Austen Dorsey
- 5 years ago
- Views:
Transcription
1 Techniques and Specific Treatment Modalities for the Active Non-Healing Wound Luke Maj, MD, MHA Assistant Professor of Radiology University of Miami, Miller School of Medicine Director of The Vein Center at Water s Edge Dermatology, Florida
2 Disclosures None
3 OVERVIEW Deep veins Superficial veins Perforator veins
4 PERFORATOR VEINS Why are they important? Perforator damage can cause significant pathology and patient symptoms Veins (spider and varicose), skin changes, ulcers, edema, pain, other symptoms. To me perforators are the most important: They cause signs and symptoms of CVI They (at times) can be the single culprit of patients problem Many providers miss them and patients return symptomatic Treatment no longer covered by insurance (in FL) except when beneath an active or healed venous ulcer You MUST treat to completion = treating perforator veins.
5 How Do I Do It? Treat axial reflux (CVI) and Pelvic Outflow Obstruction (POO) first. I take the US myself and scan the patient. I m an old school radiologist, I want to see myself I focus on areas that I can see on the skin which demonstrate skin changes. I ask the patient to specify where the symptoms are when I scan over them THIS WILL TELL YOU WHICH PERFORATORS ARE CAUSING THE PROBLEM. The patient will actually point to the area where the symptoms are. Place probe there and look. Then I compare it to the US map by my tech and see if it was identified (PS. Good way to check how good your tech is) I close the perforator (RFA, Laser, UGS) and anything that it gives off. ****BECAREFUL Majority of the time there is an arterial branch next to the perforator CLUE: Take a moment and hold the US steady and watch for pulsating tissue That s an artery.
6 How Do I Do It? What do I use to close perforators: 1. RFA 3 or 7 cm catheter If I can get away using 3 or 7cm catheter across a T-Bone perforator that is my #1 choice. 2. RFA Stylet Bit cumbersome and closure rate for me has not been as good as catheter or laser 3. Laser I prefer this method as it is quick and good success rate. Get a IV kit ($1.50), 18 or 16 gauge and insert into perforator like you are placing an IV. Or use a regular large bore needle. Through there place the laser into the IV sheath, pull back on the IV sheath so you don t burn it off. Alternative is premeasure the length of the IV sheath and get a doohickey which holds laser fiber and screws on to IV sheath. 4. Clarivein It could be done but for me there is no reimbursement so I don t use it. 5. Venaseal Likely a great method but you have to make sure that you can compress this area for 3 mins. I don t use it on perforators at this time. 5. Foam Varithena or home made The foam will go everywhere! Into perforator and into deep space. Be cautions of DVT risk. I use this method 1% Polidochanol when the insurance wont pay for Laser or RFA or they don t meet guidelines. You may have to do it more than once. Make sure that you press with US probe to close the perforator and obtain spasm of the perforator. DO not go into the perforator further than the fascia when using laser of RFA. WATCH out for artery next to perforator it should move away when you use tumescent. When finished sclerose the tributary varicosities.
7 Case Nonhealing ulcer (10 years).
8 Massive perforator with overlying tributaries
9 Case It just wont go away. Ulceration that never completely healed and skin keeps forming a new scab for years.
10 No identifiable perforator. Only tributary veins that need to be closed. Tx: Sclero
11 Case
12 Watch out for the fascial plane depth
13 Case
14 T-BONE: Easily treated even across the perforator. Laser or 3cm RFA catheter
15 Treat up to fascial plane LEFT RIGHT
16 Case JZ Reflux: BL GSV BL SSV BL Perfs BL Tribs L Femoral L Pop R Femoral L: 2x DVT
17 Pelvic Outflow Obstruction (May Turners Syndrome)
18 LEFT
19 RIGHT
20 Case Z Refluxing L GSV Refluxing L Posterior Tibial Perf L GSV Ablated No significant change. L Posterior Tibial Perforator Closed using 1% Polidochanol Foam WHY?
21 Artery?
22
23
24 Take Away. Treat to COMPLETION (including perforators, tributaries and skin veins) I quote ($) the patient and do it during other ablation procedures if no insurance coverage Lower cost to patient, Less visits (FL must have C5 of C6 to insurance coverage) Look for perforators on patients who come back with symptoms Consider IVUS for Pelvic Outflow Obstruction in patients with CEAP 3 or higher or Hx of DVT. Watch out for ARTERIES If anyone is looking to relocate to Florida or looking for a job please see me or me lukemaj@gmail.com
25 THANK YOU
26 Techniques and Specific Treatment Modalities for the Active Non-Healing Wound Luke Maj, MD, MHA Assistant Professor of Radiology University of Miami, Miller School of Medicine Director of The Vein Center at Water s Edge Dermatology, Florida
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 informationVein 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 informationPatient 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 informationVenous 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 informationChronic 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 informationNon-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 information2017 Florida Vascular Society
Current Management of Venous Leg Ulcers: How to Identify Patients with Correctable Venous Disease and Interventional Procedures to Heal and Prevent Recurrence 2017 Florida Vascular Society Bill Marston
More informationPerforators: 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 informationCurrent 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 informationThe role of ultrasound duplex in endovenous procedures
The role of ultrasound duplex in endovenous procedures Neophytos A. Zambas MD, PhD Vascular Surgeon Polyclinic Ygia, Limassol, Cyprus ΚΕΑΕΧ ΚΥΠΡΙΑΚΗ ΕΤΑΙΡΕΙΑ ΑΓΓΕΙΑΚΗΣ ΚΑΙ ΕΝΔΑΓΓΕΙΑΚΗΣ ΧΕΙΡΟΥΡΓΙΚΗΣ Pre
More informationTreatment 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 informationWhy 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 informationEndo-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 informationChronic 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 informationNew 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 informationRECOGNITION 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 informationClinical/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 informationPage 1. Ruling out deep venous obstruction prior to superficial vein treatment. Disclosures. Indications for saphenous vein ablation (SVA)
1 Ruling out deep venous obstruction prior to superficial vein treatment Deepak Sudheendra, MD, RPVI Assistant Professor of Clinical Radiology & Surgery Disclosures No financial disclosures Indications
More informationConflict 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 informationEndothermal 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 informationManagement 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 informationTREATMENT 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 informationUNDERSTANDING 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 informationAdditional 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 informationOHTAC 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 informationAMERICAN 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 informationSelection and work up for the right patients suspected of deep venous disease
Selection and work up for the right patients suspected of deep venous disease R A G H U K O L L U R I, M S, M D, R V T S Y S T E M M E D I C A L D I R E C T O R V A S C U L A R M E D I C I N E / V A S
More informationMedicare 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 informationRecurrent Varicose Veins We All See Them
We All See Them November 4, 2017 Austin, TX Arlington Heights, IL No conflicts Terminology REVAS REcurrent Varices After Surgery PREVAIT PREsence of Varices After Interventional Treatment Recurrent varices
More informationDisclosures. 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 informationDate: 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 informationGSV treatment with Radio Frequency EVRF device and CR45i catheter CLINICAL STUDY
GSV treatment with Radio Frequency EVRF device and CR45i catheter CLINICAL STUDY _ BY Dr. Thomas Niesen St Louis Surgical Consultant 226 South Wood Mills Road, Suite 49 West Chesterfield, Mo 63017 Tel:
More informationLINC, 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 informationMOCA 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 informationVein & Body Specialists at The Bellevue Hospital Spider Vein and Varicose Vein Treatments
1 Vein & Body Specialists at The Bellevue Hospital Spider Vein and Varicose Vein Treatments What are spider veins? Spider veins are dilated, small blood vessels that have a red or bluish color. They appear
More informationFIND 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 informationNew 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 informationPatient 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 informationFIND 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 informationHow 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 informationSAFETY 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 informationNCVH. Ultrasongraphy: State of the Art Vein Forum 2015 A Multidisciplinary Approach to Otptimizing Venous Circulation From Wounds to WOW
Ultrasongraphy: State of the Art 2015 NCVH New Cardiovascular Horizons Vein Forum 2015 A Multidisciplinary Approach to Otptimizing Venous Circulation From Wounds to WOW Anil K. Chagarlamudi, M.D. Cardiovascular
More informationTechnique of the VenaSeal System
Technique of the VenaSeal System Indication & Contraindications VenaSeal Indication: The Sapheon VenaSeal System is intended for the permantent, complete, endovascular adhesive closure of the great saphenous
More informationRADIOFREQUENCY 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 informationLOWER EXTREMITY VENOUS COMPRESSION ULTRASOUND. CPT Stacey Good, DO Emergency Medicine Ultrasound Fellow Madigan Army Medical Center
LOWER EXTREMITY VENOUS COMPRESSION ULTRASOUND CPT Stacey Good, DO Emergency Medicine Ultrasound Fellow Madigan Army Medical Center Learning Objectives Setup and patient positioning for optimizing success
More informationEpidemiology: Prevalence
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
More informationFind 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 informationDate: 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 informationDeep Venous Pathology. Eberhard Rabe Department of Dermatology University of Bonn Germany
Deep Venous Pathology Eberhard Rabe Department of Dermatology University of Bonn Germany Disclosures None for this presentation Consultant: Sigvaris, EUROCOM Speakers bureau: Bayer Vital, Aspen, Boehringer,
More informationComplete Evaluation of the Chronic Venous Patient: Recognizing deep venous obstruction. Erin H. Murphy, MD Rane Center
Complete Evaluation of the Chronic Venous Patient: Recognizing deep venous obstruction Erin H. Murphy, MD Rane Center Disclosure Speaker name: Erin H. Murphy... I have the following potential conflicts
More informationWHAT 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 informationAre 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 informationMedical 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 informationProtocols for the evaluation of lower extremity venous reflux: supine, sitting, or standing?
Protocols for the evaluation of lower extremity venous reflux: supine, sitting, or standing? Susan Whitelaw RVT, RDMS PURPOSE Duplex imaging of the lower extremity veins is performed to assess the deep
More informationVeClose 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 informationChronic Venous Disease: A Complex Disorder. A N Nicolaides
Chronic Venous Disease: A Complex Disorder A N Nicolaides Emeritus Professor of Vascular Surgery, Imperial College, London. Hon. Professor of Surgery, University of Nicosia Medical School, Cyprus Disclosures
More informationVaricose 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 informationFeatures compression after open and endovascular operation in vascular malformation
Features compression after open and endovascular operation in vascular malformation Sapelkin Sergey Institute of Surgery named A.V. Vishnevsky, Moscow, Russia 21.10.2017 CIRC Meeting, Grassau AV-malformations:
More informationUNDERSTANDING 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 informationVaricose 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 informationComplex Iliocaval Reconstruction PNEC. Seattle WA. Bill Marston MD Professor, Div of Vascular Surgery University of N.
Complex Iliocaval Reconstruction 2017 PNEC. Seattle WA Bill Marston MD Professor, Div of Vascular Surgery University of N. Carolina DISCLOSURES William Marston, MD Consultant/Advisory Board: Veniti, Cardinal
More informationEndovenous repair in ulcer patients: Why, when and how.
Endovenous repair in ulcer patients: Why, when and how. Johann Chris Ragg, MD CEO SWISS VX vein research labs CEO, Chief Physician angioclinic Vein Centers Berlin Munich - Zurich Counselor Venartis Inc.
More informationLet s Take a Look Venous Insufficiency Ultrasound Techniques
Let s Take a Look Venous Insufficiency Ultrasound Techniques Brent Wilkinson RVT, RDMS Steve Schomaker RVT, RDCS, RDMS Let s take a look Differentiate between normal venous flow and venous insufficiency
More informationPhlebectomy vs sclerotherapy ALESSANDRO FRULLINI MD FLORENCE - ITALY
Phlebectomy vs sclerotherapy ALESSANDRO FRULLINI MD FLORENCE - ITALY DISCLOSURE Consultant for: GloriaMed Personal background General and vascular surgeon More than 3500 stripping performed 33 years of
More informationStep by step ultrasound examination of varicose veins. Dr. Özgün Sensebat Vascular Surgeon Private Vascular Clinic Dorsten & Borken, Germany
Step by step ultrasound examination of varicose Dr. Özgün Sensebat Vascular Surgeon Private Vascular Clinic Dorsten & Borken, Germany Required technical setup: B-mode vessel imaging combined with color
More informationTreatment 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 informationCorporate 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 informationThe Use of Adjunctive Venography and Endovascular Manoeuvres In The Treatment of Saphenous Vein Insufficiency. A Prospective, Multi-centre Study
The Use of Adjunctive Venography and Endovascular Manoeuvres In The Treatment of Saphenous Vein Insufficiency A Prospective, Multi-centre Study Ramon L. Varcoe, MBBS, MS, FRACS, PhD Associate Professor
More informationThermal 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 informationCriteria 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 informationCOMMISSIONING POLICY
Ref No. 1a7.5 COMMISSIONING POLICY Surgery for venous disease of the leg (Varicosities of the Long Saphenous Vein) April 2011 CONTENTS Section Page Summary 2 1. Background 2 2. Criteria for eligibility
More informationCase. Wounds. Fundamentals of Ulcer Care. Dr. Mark Meissner Wound Case Study. Compression and Ulcer Healing Cullum NA, Cochrane Reviews 2001
Case Wounds Mark H. Meissner, MD University of Washington School of Medicine 65 yr old male physician Recurrent R medial malleolar ulcer over 5 years New R lateral malleolar ulcer Intermittently wearing
More informationMedical 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 informationEndovenous Radiofrequency and Laser Ablation
Endovenous Radiofrequency and Laser Ablation [For the list of services and procedures that need preauthorization, please refer to www.mcs.com.pr go to Comunicados a Proveedores, and click Cartas Circulares.]
More informationMindful Reflections On The Management. of Venous Ulceration. Presenter name. Title Date
C Scott McEnroe, MD, FACS Medical Director Vein Center of Virginia Sentara Vascular Specialists April 25 th, 2014 Mindful Reflections On The Management of Venous Ulceration Approximately 97 % of all statistics
More informationVenous Reflux Duplex Exam
Venous Reflux Duplex Exam GWENDOLYN CARMEL, RVT PHYSIOLOGIST, DEPARTMENT OF VASCULAR SURGERY NEW JERSEY VETERANS HEALTHCARE CENTER EAST ORANGE, NJ PURPOSE: To identify patterns of incompetence and which
More informationA 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 informationStarting with deep venous treatment
Starting with deep venous treatment Carsten Arnoldussen, MD Interventional Radiologist Maastricht University Medical Centre, Maastricht VieCuri Medical Centre, Venlo The Netherlands Background Maastricht
More informationChronic Swelling, Pain, and Ulceration in the Left Lower Extremity
WHAT WOULD YOU DO? Chronic Swelling, Pain, and Ulceration in the Left Lower Extremity MODERATOR: BROOKE SPENCER, MD, FSIR PANEL: LAWRENCE RUSTY HOFMANN, MD; MARK J. GARCIA, MD, FSIR, FACR; AND BRENT T.
More informationAnatomy. Patterns of reflux. Technique. Testing Reflux time Patient position. Difficult! Learning. NOT system optimisation. Clinical Assesment
Anatomy Patterns of reflux Awareness Technique Testing Reflux time Patient position Difficult! Learning NOT system optimisation Enlarged Clinical Assesment Twisted Where are the symptoms? Why they are
More informationDetermine 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 informationTessari L. Nouvelle technique d'obtention de la sclero-mousse. Phlebologie 2000;53:129.
Appendix 1 to Microsclerotherapy Standard AUSTRALASIAN COLLEGE OF PHLEBOLOGY CLINICAL PROCEDURES CP - Microsclerotherapy - Clinical procedure 1 PURPOSE This procedure summarises the actions required to
More informationThe 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 informationEndovenous laser ablation of varicose perforating veins with the 1470-nm diode laser using the radial fibre slim
Published online on 15 November 2012 Phlebology, doi: 10.1258/phleb.2012.012072 Endovenous laser ablation of varicose perforating veins with the 1470-nm diode laser using the radial fibre slim Christof
More informationPriorities 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 informationClinical 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 informationMedStar 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 informationManagement of Side Branches and Perforating Veins
Management of Side Branches and Perforating Veins T. Noppeney Center for Vascular Diseases: Outpatient Dept. Obere Turnstrasse, Dept. for Vascular Surgery Martha-Maria Hospital (Academic Teaching Hospital
More informationPHLEBOLOGY. 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 informationThrombosis of the Saphenous Vein Stump after Varicose Vein Surgery
2016 Annals of Vascular Diseases doi:10.300/avd.oa.16-000 Original Article Thrombosis of the Saphenous Vein Stump Varicose Vein Surgery Hiroto Rikimaru, MD, PhD We evaluated thrombus extension in the proximal
More informationSURGICAL 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 informationHistory is Flawed. A New Paradigm for Abdominal & Pelvic Venous Disorders
History is Flawed A New Paradigm for Abdominal & Pelvic Venous Disorders Mark H. Meissner, MD Peter Gloviczki Professor of Venous & Lymphatic Medicine University of Washington School of Medicine Disclosures
More informationAs with any intervention, selection of an appropriate
DVT: ccess Decisions for Interventions ssessing the advantages and disadvantages of venous access options is crucial for safe and successful DVT intervention. Y JOHN. KUFMN, MD, MS, FSIR, FH, FCIRSE, EIR
More informationTreatment 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 informationSCIENTIFIC PROGRAMME
9 th EVF HOW HANDS-ON WORKSHOP on VENOUS DISEASE Grand Resort, Limassol, Cyprus, 25-27 October 2018 SCIENTIFIC PROGRAMME Thursday 25 October 2018 07.30 Welcome Chronic Venous Disease (CVD) - Basics 07.45
More informationSURGICAL 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 informationSURGICAL 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 informationEndovenous Laser Ablation (EVLA) to Treat Recurrent Varicose Veins
Eur J Vasc Endovasc Surg (2011) 41, 691e696 Endovenous Laser Ablation (EVLA) to Treat Recurrent Varicose Veins N.S. Theivacumar, M.J. Gough* Leeds Vascular Institute, The General Infirmary at Leeds, Great
More information