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16 February 2012

American varicose vein report shows procedures are effective and durable

The 'First Varicose Vein Module Report 2012" from the American Venous Registry (AVR) has shown that varicose vein ablation procedures were 'remarkably durable" and that treatment for varicose veins was generally 'extremely effective". The report is the first publication from the American Venous Registry (AVR), an initiative from the American Venous Forum. The AVR is an online database developed by the Forum and Dendrite Clinical Systems.

“The American Venous Forum has developed the AVR to foster open, on-going and collaborative dialogue among physicians specializing in the treatment of venous and lymphatic diseases,” said Dr Seshadri Raju, President American Venous Forum. “This first report underlines our commitment to providing research, education for the venous patient. We hope that these series of reports utilising data from the AVR will further our understanding of, and how to effectively treat, venous disease.”

The Varicose Vein Module currently has over 4,000 entries from 40 sites actively participating in the registry. This first report focuses on procedures spanning the calendar years 2007-2011, comprising 3,930 patient-entries, whilst the follow-up analyses is based on 6,472 follow-up. According to the AVF, this report involves the first ever sampling of demographics, disease profile, diagnostics, treatment and outcomes of chronic venous insufficiency management across the United States.

“The first report allows us to draw valid conclusions regarding varicose vein treatment efficacy, particularly in regards to procedures and patient groups,” said Dr Brajesh K Lal, Chairman of the Steering Committee for the AVR, Associate Professor and Chief of Vascular Surgery, Physiology & Bioengineering, University of Maryland, Baltimore. “This will make it a powerful tool for the development of treatment guidelines, evidence-based modification of public policy and re-direction of healthcare resources.”

Key data from the report showed:

  • Procedural and outcomes data from surgery, sclerotherapy, radio frequency ablation, endovenous laser ablation and combinations of treatments.

  • The majority of patients recorded in the database were Caucasian (70.5%) and female (76.6%), with a median age of 54.

  • Endoluminal laser ablation was the most-frequently used vein ablation modality in this cohort (60.2%) and sclerotherapy was the least used (16.3%); surgery and radiofrequency ablation were employed in equal measure (33.9% and 32.6% respectively).

  • In sclerotherapy procedures, 91.7% of injections were ultrasound guided with sodium tetradecyl sulphate the sclerosant of choice (96.1% of procedures).

  • The median venous clinical severity score (VCSS) on presentation was 7 while it was significantly reduced to 4 at 35 days after the patient"s first procedure (p=0.001). Pre-procedural pain at the initial encounter was also significantly reduced 35 days after the patient"s first intervention for both treated left lower extremities (p=0.001) and treated right lower extremities (p=0.002).

  • The overall rates of immediate post-procedural complications were low, with local complications immediately after the procedure occurring in 1.1% of interventions performed on the right lower extremity and 0.6% of procedures on the left (bilateral procedures incurred a higher complication rate of 3.6%.

  • The 3-year rate of freedom from complications was approximately 85%.

“Dendrite is delighted to see the first published data from the AVR"s varicose vein module, which we believe will be of great assistance in developing effective treatment strategies for venous disease,” said Dr Peter Walton, Managing Director, Dendrite Clinical Systems. “We look forward to working with the AVF in launching the next modules of the American Venous Registry in the coming months.”