Recurrent Varicose Veins We All See Them
|
|
- Berenice Powell
- 6 years ago
- Views:
Transcription
1 We All See Them November 4, 2017 Austin, TX Arlington Heights, IL
2 No conflicts
3 Terminology REVAS REcurrent Varices After Surgery PREVAIT PREsence of Varices After Interventional Treatment Recurrent varices Reappearance of varicose veins in an area previously treated successfully Residual varices Varicose veins remaining after treatment
4 Clinical definition includes True recurrences Residual refluxing veins Varicose veins caused by progression of the disease Frequency Estimated 20-80% depending on duration of follow up No data on the socioeconomic consequences (2001)
5 Clinical and Instrumental diagnosis Hx, PE, CW doppler essential but do not give precise diagnosis Duplex ultrasound primary choice Venography valuable tool Iliac CT, MRV Pelvic Evaluation
6 Historical development of systematic pretreatment evaluation and long term follow up 1998 Consensus group under the guidance of M. Perrin developed new classification system (REVAS) A revision of inconsistent International venous nomenclature begun-deep and superficial venous systems, lower extremities CEAP Classification
7 Classification Six items (2001) T Topographic sites e.g. T9 for groin S Sources of reflux 0-7, e.g. S1 pelvic/abdomen R Degree of reflux- +/-
8 Classification N Nature of Source P Contribution from a persistent trunk F Possible contributing factors
9 REVAS Recurrent veins after surgery are a common, complex and costly problem for the patients and physicians who treat venous disease. M. Perrin 2001
10 Post Procedure Uniform identification of the causes and patterns of recurrence has not been reported. Mainly because of the inconsistency in defining recurrence, the initial therapy performed and length of follow up. Nicos Labropoulos, Rutherford s Vascular Surgery, 8th edition
11 General facts from Rutherfords s Vascular Surgery, 8th Edition, Chapter 18 About 75% REVAS symptomatic Sources are multiple SFJ area 50% No source 10% Pelvic origin 17% About 17% have IP s
12 General facts Rutherford s Higher percentage of patients have skin changes Older mean age Below the knee saphenous trunk remnant segments have higher prevalence of reflux (GSV stripped to knee; SSV ligated)
13 2013 Journal of Vascular Surgery, Vol.57, No.3, , Maresa Brake, et al. Pathogenesis and Etiology of Recurrent Varicose Veins (RVV) % of patients Inadequate treatment, disease progression, neovascularization
14 References Phlebolymphology, 2014; 21(3): Phlebolymphology, 2015; 22(1):5-11 The Scientific World Journal, Volume 2014 (2014), Article ID , 7 pages,
15 Recurrent veins after thermal ablation (REVATA) 2012 Ron Bush, Journal of Vascular and Endovascular Surgery
16 Conclusions Debilitating and costly problem common Document patient selection, DUS, accurate treatment and follow up procedures Use accepted international venous anatomic nomenclature, CEAP, disease scores e.g. VCSS
17 Conclusions Despite frequent occurrences, etiology and pathogenesis poorly understood Factors leading to recurrence after sclerotherapy and endothermal treatment may be different than surgery
18 Sclerotherapy-Endovenous Chemical Ablation Visual macro and micro DUS aided guided Truncal, tributary, IP Liquid traditional, MOCA-mechanical chemical ablation Foam office generated-air, CO2, CO2O2 Proprietary Varithena Combination with other modalities laser, glue
19 Sclerotherapy Historical perspective Before DUS French Tournay Top down SFJ Swiss Sigg Open needle Irish Fegan Bottom up IP s
20 Sclerotherapy Mechanism of action produces endothelial damage Introduction of a foreign substance into the vein lumen Direct endothelial cell damage complex interaction Endosclerosis Endofibrosis includes entire length of abnormal vein
21 Sclerotherapy DUS Evaluation and Guided Treatment Knight RM, Vin F, Zygmunt JA. Ultrasonic guidance of injections in to the superficial venous system. In: Davy A, Stemmer R, eds. Phlebologie 89. UIP Presentation Strasbourg, FR
22 Sclerotherapy Outcome papers Various rates of recurrence generally higher than surgery DUS Set the stage for reliable, reproducible method to evaluate, treat and follow multiple presentations of superficial venous insufficiency
23 - Past Long history of post-procedural (surgery, sclerotherapy) recurrent veins clinical exam Post-surgery SFJ neovascularization Re-do surgery difficult Some hope for DUS guided sclerotherapy
24 Sclerotherapy ( ) Fegan sclerotherapy Bottom Up Standing evaluation, placement of needle into veins, inject in recumbent/supine position Compression wrap Ambulation Reduction of large varicose veins. Clinical follow up.
25 Sclerotherapy ( ) DUS Diagnostic evaluation established upright eval of SFJ, SPJ, total superficial system, deep system. All size GSV/SSV. DUS guided sclerotherapy Liquid sclerosant (Sotradecol) Compression Ambulation Up to 90% GSV fibrosis SFJ to knee (2 years)
26 Sclerotherapy (2000-present) Truncal vein therapy endovenous laser ablation of GSV Sclerotherapy for tributaries and and IP s mainly liquid >95% fibrosis of GSV from SFJ to knee
27 Sclerotherapy Varithena Polidocanol injectable foam-fda approved GSV insufficiency. Large scale multicenter use will determine if long term patient outcomes compare to published studies.
28 Sclerotherapy Follow up 30 years Clinical visible veins, symptoms CW doppler standing DUS Patients have tolerated all outpatient ambulatory non-anesthesia treatments well and with appropriate counseling return.
29 Sclerotherapy Post-sclerotherapy recurrences GSV AK + BK SFJ area neovascularization not demonstrated. Have imaged groin lymph node varices. Superior vessels (superficial epigastric, superficial circumflex, pudendal) independent evaluation Thigh distal thigh IP
30 Sclerotherapy Post-sclerotherapy recurrences GSV AK + BK Proximal medial calf anterior and posterior arch varices. IP s with tributary veins. Distal medial calf posterior arch veins. Intersaphenous varices. Tributaries from IP s
31 Sclerotherapy Post-sclerotherapy recurrences GSV AK + BK BK Independent varices from postero-medial IP sgastrocnemius muscle
32 Sclerotherapy Post-sclerotherapy recurrences SSV SSV is direct continuation of PAGSV SSV has origin other than SPJ in popliteal fossa Medial and lateral branch communications Various IP s includes mid- and distal calf
33 Sclerotherapy For all therapeutic modalities recurrent varicose veins increase with accurate diagnosis and long term follow up Standardized nomenclature anatomy, diagnostic evaluation, treatment modality
34 Sclerotherapy Primary and secondary therapy in wide range of superficial venous insufficiency patterns Must understand venous anatomy normal and abnormal including DUS Know sclerosants mechanism of action, safety profile and concentrations
35 Sclerotherapy Develop long term strategy. Includes discussion with patient about life long venous insufficiency In office protocols to standardize evaluation and treatment for long term follow up
36 Sclerotherapy Participate in patient reporting of all treatment modalities Will add insights into treatment outcomes relating to the causes of recurrent varicose veins and the natural history of venous insufficiency
37 Conclusion Estimated 13-65% recurrent varices posttreatment Socioeconomic consequences Cost, complications Possible mechanisms Tactical errors Technical problems
38 Conclusion Disease evolution Previously unaffected superficial veins or perforator veins become incompetent Genetic and other constitutional risk factors Family history not fully understand Genome wide studies with large sample size
39 Conclusion Recurrent Varicose Vein - Treatment Specific to recurrent pattern Ultrasound guided foam (UGFS) sclerotherapy IB recommendation European guidelines More needs to be done
Venous 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 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 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 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 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 informationSegmental GSV reflux
Segmental GSV reflux History of presentation A 43 year old female presented with right lower extremity varicose veins and swelling. She had symptoms of aching, heaviness and tiredness in the right leg.
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 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 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 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 informationThe role of new reflux of accessory veins in clinical recurrence of varicose veins after endovascular laser ablation (EVLA)
Cyprus Society of Vascular and Endovascular Surgery The role of new reflux of accessory veins in clinical recurrence of varicose veins after endovascular laser ablation (EVLA) Toursidis Achilleas, MD,
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 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 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 informationLe 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 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 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 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 informationR. G. Bush, 1 P. Bush, 1 J. Flanagan, 2 R. Fritz, 3 T. Gueldner, 4 J. Koziarski, 5 K. McMullen, 6 and G. Zumbro Introduction
e Scientific World Journal, Article ID 505843, 7 pages http://dx.doi.org/10.1155/2014/505843 Research Article Factors Associated with Recurrence of Varicose Veins after Thermal Ablation: Results of The
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 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 informationHow 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 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 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 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 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 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 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 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 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 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 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 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 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 informationDuplex Ultrasound Investigation of the Veins of the Lower Limbs after Treatment for Varicose Veins e UIP Consensus Document
Eur J Vasc Endovasc Surg (2011) 42, 89e102 LEADING ARTICLE Duplex Ultrasound Investigation of the Veins of the Lower Limbs after Treatment for Varicose Veins e UIP Consensus Document M. De Maeseneer a,b,
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 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 informationControversies & updates in Vascular Surgery. Paris - february
Controversies & updates in Vascular Surgery Paris - february 09 2019 Venous session Recurrence at the popliteal fossea Pathogenesis and duplex investigation Philippe LEMASLE Le Chesnay - France I have
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 informationLong-term vein diameter reduction by perivenous hyaluronan instead of tumescence for endovenous procedures
Long-term vein diameter reduction by perivenous hyaluronan instead of tumescence for endovenous procedures Johann Chris Ragg, MD founder & head of angioclinic Vein Centers Europe founder & head of SWISS
More informationTreatment 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 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 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 informationWhat can we learn from randomized trials comparing endovenous and open surgery for primary varicosis? an overview Prof. Dr. Thomas M.
What can we learn from randomized trials comparing endovenous and open surgery for primary varicosis? an overview Prof. Dr. Thomas M. Proebstle Department of Dermatology, University Medical Center Mainz,
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 informationCurrent Management of C0s patient
Current Management of C0s patient M. Perrin Vascular Surgery, Lyon, France 1 AIM of the PRESENTATION - 1 st to estimate the prevalence of C 0s patient - 2 d to evaluate its current management - 3d to suggest
More informationSURGICAL 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 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 informationLower Extremity Venous Insufficiency Evaluation
VASCULAR TECHNOLOGY PROFESSIONAL PERFORMANCE GUIDELINES Lower Extremity Venous Insufficiency Evaluation This Protocol was prepared by members of the Society for Vascular Ultrasound (SVU) as a template
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 informationN.S. Theivacumar, R.J. Darwood, M.J. Gough*
Eur J Vasc Endovasc Surg (2009) 37, 477e481 Endovenous Laser Ablation (EVLA) of the Anterior Accessory Great Saphenous Vein (): Abolition of Sapheno-Femoral Reflux with Preservation of the Great Saphenous
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 informationIntroduction. Background Evidence System of examination Diagnoses & Variants Final actions Limitation of the examination
Rule in DVT Introduction Background Evidence System of examination Diagnoses & Variants Final actions Limitation of the examination BACKGROUND Common presentation Influence initial management NICE Guidelines
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 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 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 informationClosurefast 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 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 informationSchedule of Benefits. for Professional Fees Vascular Procedures
Schedule of Benefits for Professional Fees 2018 Vascular Procedures ANASTOMOSIS RULES 820 Arteriovenous anastomosis in arm 1453 Arteriovenous anastomosis, open by basilic vein transposition 1465 Splenorenal
More informationResults and Significance of Colour Duplex Assessment of the Deep Venous System in Recurrent Varicose Veins
Eur J Vasc Endovasc Surg 34, 97e101 (2007) doi:10.1016/j.ejvs.2007.02.011, available online at http://www.sciencedirect.com on Results and Significance of Colour Duplex Assessment of the Deep Venous System
More informationThe Evaluation & Treatment of Pelvic Venous Disorders
The Evaluation & Treatment of Pelvic Venous Disorders Mark H. Meissner, MD Professor of Surgery University of Washington School of Medicine Seattle, Washington Pelvic Venous Disorders Pelvic Congestion
More informationPROVIDER 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 informationDuplex Ultrasound Outcomes following Ultrasound-guided Foam Sclerotherapy of Symptomatic Recurrent Great Saphenous Varicose Veins
Eur J Vasc Endovasc Surg (2011) 42, 107e114 Duplex Ultrasound Outcomes following Ultrasound-guided Foam Sclerotherapy of Symptomatic Recurrent Great Saphenous Varicose Veins K.A.L. Darvall a,b, *, G.R.
More informationHigh Level Overview: Venous Anatomy of Lower Extremities. Anatomy of a Vein 5/11/2015. Barbara Deusterman, RN
High Level Overview: Venous Anatomy of Lower Extremities Barbara Deusterman, RN What does this anatomy lecture have to do with visually guided sclerotherapy (VGS)? May 11, 2015 2 Anatomy of a Vein Almeida,
More informationThe Incidence, Clinical Importance and Management of Incompetent Gastrocnemius Vein
2016 Annals of Vascular Diseases doi:10.3400/avd.oa.15-00105 Original Article The Incidence, Clinical Importance and Management of Incompetent Gastrocnemius Vein Mitsuyuki Nakayama, MD Purpose: To report
More informationo 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 informationVarithena 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 informationN.S. Theivacumar, R. Darwood, M.J. Gough* KEYWORDS Neovascularisation; Recurrence; Varicose vein; EVLA; Sapheno-femoral junction; GSV
Eur J Vasc Endovasc Surg (2009) 38, 203e207 Neovascularisation and Recurrence 2 Years After Varicose Vein Treatment for Sapheno-Femoral and Great Saphenous Vein Reflux: A Comparison of Surgery and Endovenous
More information[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 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 informationRare Vascular Anomalies in the Femoral Triangle During Varicose Vein Surgery
Korean J Thorac Cardiovasc Surg 2017;50:99-104 ISSN: 2233-601X (Print) ISSN: 2093-6516 (Online) CLINICAL RESEARCH https://doi.org/10.5090/kjtcs.2017.50.2.99 Rare Vascular Anomalies in the Femoral Triangle
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 informationPreservation of saphenous trunks ASVAL
Preservation of saphenous trunks ASVAL S. Chastanet, P. Pittaluga DISCLOSURE OF INTEREST I do not have any relevant financial relationships with any commercial interest Traditionnal Concept of SVI Descending
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 informationLOWER LIMB DOPPLER ULTRASOUND FOR THE STUDY OF VENOUS INSUFFICIENCY
Revista Chilena de Radiología. 2009; 15(4): -. 1 LOWER LIMB DOPPLER ULTRASOUND FOR THE STUDY OF VENOUS INSUFFICIENCY Dr. Paola Paolinelli G. Diagnostic Imaging Service, Clinica Las Condes, Santiago, Chile.
More information43 rd BIANNUAL CONGRESS. SEPTEMBER , 2018 Hotel Delta Montreal, CANADA
43 rd BIANNUAL CONGRESS SEPTEMBER 21-22-23, 2018 Hotel Delta Montreal, CANADA PROGRAM CO-CHAIRMEN Janna Bentley, Kelowna, BC, Canada President of the Canadian Society of Phlebology Registered Vascular
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 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 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 informationDescription and Management of C0s patient. M. Perrin, Vascular Surgery, Lyon, France
Description and Management of C0s patient M. Perrin, Vascular Surgery, Lyon, France 1 No disclosure of interest to declare for this presentation 2 AIM of the PRESENTATION 1 st to estimate the prevalence
More informationDoppler ultrasound in the evaluation of chronic venous insufficiency: A step-by-step morphological and hemodynamic review
Doppler ultrasound in the evaluation of chronic venous insufficiency: A step-by-step morphological and hemodynamic review Poster No.: C-3206 Congress: ECR 2010 Type: Educational Exhibit Topic: Vascular
More informationEndovenous 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 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 informationISSN X (Print)
Scholars Journal of Applied Medical Sciences (SJAMS) Sch. J. App. Med. Sci., 2015; 3(8B):2841-2846 Scholars Academic and Scientific Publisher (An International Publisher for Academic and Scientific Resources)
More informationHemorroids and pelvic venous congestion: venous embolization is it efficient and sufficient?
Hemorroids and pelvic venous congestion: venous embolization is it efficient and sufficient? Milka GREINER MD American Hospital of Paris Hôpital Pitié-Salpêtrière Paris I do not have any potential conflict
More informationClinico-Anatomical and Radiological Correlation of Varicose Veins of Lower Limb A Cross-sectional Study
ORIGINAL RESEARCH www.ijcmr.com Clinico-Anatomical and Radiological Correlation of Varicose Veins of Lower Limb A Cross-sectional Study Lalatendu Swain 1, Mamata Singh 2, Prabhat Nalini Rautray 3 ABSTRACT
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 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 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 informationTAKING YOUR PRACTICE TO THE NEXT LEVEL
43 rd BIANNUAL CONGRESS TAKING YOUR PRACTICE TO THE NEXT LEVEL SEPTEMBER 21-22-23, 2018 Hotel Delta Montreal, CANADA PROGRAM CO-CHAIRMEN Janna Bentley, Kelowna, BC, Canada President of the Canadian Society
More informationOriginal Policy Date
MP 7.01.104 Treatment of Varicose Veins Medical Policy Section Surgery Issue 12/2013 Original Policy Date 12/2013 Last Review Status/Date Local policy/12/2013 Return to Medical Policy Index Disclaimer
More informationTechniques and Specific Treatment Modalities for the Active Non-Healing Wound. Luke Maj, MD, MHA
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
More informationPercutaneous treatment with radiofrequency ablation of varicose veins recurring after Ann. Ital. Chir., , 5:
Percutaneous treatment with radiofrequency ablation of varicose veins recurring after Ann. Ital. Chir., 2017 88, 5: 438-442 vein stripping surgery pii: S0003469X17027725 A preliminary study Giovanni Turtulici*,
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 informationSUMMARY INTRODUCTION. Download original publication in PDF format
J Vasc Surg 2004 ;39 :189-95 Olivier Pichot, MD,a Lowell S. Kabnick, MD,b Denis Creton, MD,c Robert F. Merchant, MD,d Sanja Schuller-Petroviæ, MD, PhD,e and James G. Chandler, MD,f Grenoble, France; Morristown,
More informationVaricose 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 informationLinda Antonucci, RPhS, RVT, RDCS
Linda Antonucci, RPhS, RVT, RDCS DISCLOSURE Linda Antonucci, RPhS, RVT, RDCS I have no financial relationships to disclose relevant to this talk. SIMILARITIESBETWEEN ARTERIES AND VEINS Composed of three
More information