Overview

These sessions will be helpful in expanding physician knowledge base and improving clinical confidence and effectiveness in treating patients with CLTI. 

• Session 1
• Session 2

Funding for this activity is provided by a grant from CMSS aimed to promote diagnostic excellence across the field of medicine.

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Pre- and Post-Surveys

Before you watch the recordings, you are encouraged to take the roundtable pre-survey to evaluate if the guideline recommendations are easy to translate into daily clinical practice.

Take the Pre-Survey

Once you have completed the recordings, you are encouraged to take the post-survey. This will help gauge what you have learned. If you are only going to watch one recording, please take the surveys before and after; if you are going to watch all of the recordings, take the pre-survey before you watch the first one and the post-survey after you watch the final one.

Take the Post-Survey

Sessions

Session 1: Structured Decision-Making in the CLTI Patient: Understanding the PLAN 

The focus of this webinar will be to review the patient PLAN algorithm based on the Global Vascular Guidelines in CLTI. The importance of staging to guide the course of treatment and potential alterations in the treatment plan will be reviewed. The use of the VQI, WIfI, and GLASS applications to facilitate evidence-based decision-making for CLTI patients will be reviewed.

Case presentations will illustrate how to practically use the PLAN approach in specific clinical scenarios.

Session 2: Informed Decision-Making In CLTI

Held in-person at VAM24, this session will focus on shared, patient-centered decision making to individualize treatment recommendations. The importance of staging and setting patients’ expectations to facilitate decision making for CLTI patients will be reviewed.

This recording also includes a live patient panel.

Recommended Reading

1. Mills Sr JL, Conte MS, Armstrong DG, Pomposelli FB, Schanzer A, Sidawy AN, et al. The Society for Vascular Surgery Lower Extremity Threatened Limb Classification System: risk stratification based on wound, ischemia, and foot infection (WIfI). J Vasc Surg 2014;59:220e234.e1-2.
2. Conte MS, Bradbury AW, Kolh P, White JV, Dick F, Fitridge R, Mills JL, Ricco JB, Suresh KR, Murad MH. Global vascular guideline on the management of chronic limb-threatening ischemia. J Vasc Surg. 2019;69(6s):1-122.
3. Armstrong DG, Tan TW, Boulton AJM, Bus SA. Diabetic Foot Ulcers: A Review. JAMA. 2023 Jul 3;3 Wijnand JGJ, Zarkowsky D, Wu B, van Haelst STW, Vonken EPA, Sorrentino TA, Pallister Z, Chung J, Mills JL, Teraa M, Verhaar MC, de Borst GJ, Conte MS. The Global Limb Anatomic Staging System (GLASS) for CLTI: Improving Inter-Observer Agreement. J Clin Med. 2021 Aug 4;10(16):3454.
4. van Haelst STW, Teraa M, Moll FL, de Borst GJ, Verhaar MC, Conte MS. Prognostic value of the Society for Vascular Surgery Wound, Ischemia, and foot Infection (WIfI) classification in patients with no-option chronic limb-threatening ischemia. J Vasc Surg. 2018 Oct;68(4):1104-1113.e1. doi: 10.1016/j.jvs.2018.02.028. Epub 2018 May 22. PMID: 29802042.
5. Leithead C, Novak Z, Spangler E, Passman MA, Witcher A, Patterson MA, Beck AW, Pearce BJ. Importance of postprocedural Wound, Ischemia, and foot Infection (WIfI) restaging in predicting limb salvage. J Vasc Surg. 2018 Feb;67(2):498-505.
6. Bontinis V, Bontinis A, Koutsoumpelis A, Giannopoulos A, Ktenidis K. A systematic review and meta-analysis of GLASS staging system in the endovascular treatment of chronic limb-threatening ischemia. J Vasc Surg. 2023 Mar;77(3):957-963.e3.

Overview

This session is based on the 2023 Society for Vascular Surgery, American Venous Forum, and American Vein and Lymphatic Society Clinical Practice Guidelines for the Management of Varicose Veins of the Lower Extremities. 

Pre- and Post-Course Surveys

Before you watch the recording, you are encouraged to take the roundtable pre-survey to evaluate if the guideline recommendations are easy to translate into daily clinical practice.

TAKE THE PRE-COURSE SURVEY

Once you have completed the recording, you are encouraged to take the post-survey. This will help gauge what you have learned. 

TAKE THE POST-COURSE SURVEY

Session Recording

This session will be helpful in expanding physician knowledge base and improving clinical confidence and effectiveness in treating patients with varicose veins. The session will address the latest guidelines in the diagnostic evaluation of patients with varicose veins, using duplex scanning. It will also cover adjuvant medical treatment with available nutritional supplements, compression therapy, open surgical and percutaneous endovenous therapies for lower extremity varicosities, including thermal and non-thermal ablations of the great, small and accessory saphenous veins. The treatment of thrombotic complications of venous interventions and superficial thrombophlebitis as well as concomitant or staged treatment of varicose tributaries with sclerotherapy or mini-phlebectomy will also be discussed.

The faculty will use case vignettes to design treatment strategies and demonstrate how to put the recommendations from the evidence-based clinical practice guidelines into practice.

Overview

This session is based on the 2022 Society for Vascular Surgery, American Venous Forum, and American Vein and Lymphatic Society Clinical Practice Guidelines for the Management of Varicose Veins of the Lower Extremities. 

Pre- and Post-Course Surveys

Before you watch the recording, you are encouraged to take the roundtable pre-survey to evaluate if the guideline recommendations are easy to translate into daily clinical practice.

Take the Pre-Course Survey

Once you have completed the recording, you are encouraged to take the post-survey. This will help gauge what you have learned. 

Take the Post-Course Survey

Session Recording

This session will be helpful in expanding physician knowledge base and improving clinical confidence and effectiveness in treating patients with varicose veins. The session will address diagnostic evaluation of patients with varicose veins, using duplex scanning to confirm pathologic superficial truncal reflux. The session will also cover compression therapy, open surgical and percutaneous endovenous therapies for lower extremity varicosities, including thermal and non-thermal ablations of the great, small and accessory saphenous veins. The treatment of perforating veins and the concomitant treatment of varicose tributaries with sclerotherapy or mini-phlebectomy will also be discussed. 

Recommended Readings

1. Gloviczki P, Lawrence PF, Wasan SM, Meissner MH, Almeida J, Brown K, et al.
   
   The 2022 Society for Vascular Surgery, American Venous Forum, and American Vein and Lymphatic Society Clinical Practice Guidelines for the Management of Varicose Veins of the Lower Extremities.J Vasc Surg Venous Lymphat Disord. 2022, https://doi.org/10.1016/j.jvsv.2022.09.004.
   
    
2. Farah MH, Nayfeh T, Urtecho M, Hasan B, Amin M, Sen I, Wang Z, Prokop LJ, Lawrence PF, Gloviczki P, Murad MH. A systematic review supporting the Society for Vascular Surgery, the American Venous Forum, and the American Vein and Lymphatic Society guidelines on the management of varicose veins. J Vasc Surg Venous Lymphat Disord. 2022 Sep;10(5):1155-1171.
   
    
3. Lurie F, Passman M, Meisner M, Dalsing M, Masuda E, Welch H, Bush RL, Blebea J, Carpentier PH, De Maeseneer M, Gasparis A, Labropoulos N, Marston WA, Rafetto J, Santiago F, Shortell C, Uhl JF, Urbanek T, van Rij A, Eklof B, Gloviczki P, Kistner R, Lawrence P, Moneta G, Padberg F, Perrin M, Wakefield T. The 2020 update of the CEAP classification system and reporting standards. J Vasc Surg Venous Lymphat Disord. 2020 May;8(3):342-352.
   
    
4.  Masuda E, Ozsvath K, Vossler J, Woo K, Kistner R, Lurie F, Monahan D, Brown W, Labropoulos N, Dalsing M, Khilnani N, Wakefield T, Gloviczki P. The 2020 appropriate use criteria for chronic lower extremity venous disease of the American Venous Forum, the Society for Vascular Surgery, the American Vein and Lymphatic Society, and the Society of Interventional Radiology. J Vasc Surg Venous Lymphat Disord. 2020 Jul;8(4):505-525.e4. 
   
    
5. Gloviczki P, Comerota AJ, Dalsing MC, Eklof BG, Gillespie DL, Gloviczki ML, Lohr JM, McLafferty RB, Meissner MH, Murad MH, Padberg FT, Pappas PJ, Passman MA, Raffetto JD, Vasquez MA, Wakefield TW; Society for Vascular Surgery; American Venous Forum. The care of patients with varicose veins and associated chronic venous diseases: clinical practice guidelines of the Society for Vascular Surgery and the American Venous Forum. J Vasc Surg. 2011 May;53(5 Suppl):2S-48S.
   
    
6. Bhushan R, Lebwohl MG, Gottlieb AB, Boyer K, Hamarstrom E, Korman NJ, Kirsner RS, Sober AJ, et al. Translating Psoriasis Guidelines into Practice. Important Gaps revealed. J Am Acad Dermatol. 2015

Continue to Part II

The Society for Vascular Surgery offers several different types of clinical practice documents and tools to assist our members and the healthcare industry.

Clinical Practice Guidelines*

The Society's guidelines evaluate the evidence in the scientific literature, assess the benefits and harms of a particular treatment and enable healthcare providers to select the best care for a patient based on his or her preferences. The Society develops evidence-based clinical practice guidelines to aid its members and their patients in the decision-making process.

Access the guidelines 

*The Society for Vascular Surgery (SVS) develops evidenced-based clinical practice guidelines as a resource to assist members in the practice of vascular surgery. The guideline recommendations contained herein are based on a recent review of published evidence. They reflect the available body of evidence, and their applicability reflects the limitations of that data and are subject to reassessment and revision as new knowledge emerges. Given these limitations, clinical practice guidelines do not represent a statement of the standard of care, nor do they substitute for clinician judgment or supplant patient preference or shared decision-making. The Society of Vascular Surgery recognizes that departure from guidelines may be warranted when, in the reasonable judgment of the treating clinician, such course of action is indicated by the clinical presentation of the patient, limitations of available resources, advances in knowledge or technology, or patient preference. The reader must rely solely on their own judgment to determine what practices and procedures, whether included in this practice guideline or not, are appropriate for them, their patient, their institution, or their practice.

Translating Guidelines Into Clinical Practice

GVG-CLTI Series

In the fall of 2022, expert moderators and panelists came together to host a series of interactive roundtables addressing how to incorporate the Global Vascular Guidelines (GVG) on the Management of Patients with Chronic Limb-threatening Ischemia (CLTI) into practice. The three sessions are helpful in expanding physicians' knowledge base and improving clinical confidence and effectiveness in treating patients with CLTI. 

Varicose Veins

Vascular experts hosted an interactive session addressing diagnostic evaluation of patients with varicose veins, using duplex scanning to confirm pathologic superficial truncal reflux. The session also covered compression therapy, and open surgical and percutaneous endovenous therapies for lower extremity varicosities, including thermal and non-thermal ablations of the great, small and accessory saphenous veins. The treatment of perforating veins and the concomitant treatment of varicose tributaries with sclerotherapy or mini-phlebectomy were also discussed. 

Part 1

Part 2

Decision-Making in the CLTI Patient Series

In 2024, the Decision-Making in the CLTI Patient Series was launched through the support of a Council of Medical Specialty Societies (CMSS) grant. These sessions featured expert moderators and faculty from around the country. By informing the physician's experience, boosting clinical confidence, and increasing treatment efficacy for patients with CLTI, the sessions aim to drive overall improvement in patient outcomes.

Perioperative Care in Vascular Surgery: Recommendations from ERAS and SVS

In the fall of 2024, expert faculty reviewed the recommendations for perioperative care based on the consensus statements developed by the Enhanced Recovery After Surgery (ERAS) Society and the Society for Vascular Surgery (SVS) in 2022, 2023 and 2024. In addition, practical examples of how ERAS protocols have been implemented in clinical practice are discussed.

Multi-specialty Consensus Documents

The Society occasionally participates in Multi-specialty Consensus Documents with external organizations. Topics include competencies, perioperative care, interventional radiology, cardiology and performance measures. 

Reporting Standards

Reporting standards are intended to provide uniformity of definitions and classifications for comparative purposes. They are instructive on how to report information from clinical studies in a consistent manner to make it easy for the reader to compare results. 

Credentialing Resources 

Find papers and information on vascular credentialing and clinical competencies. 

Best Practice Documents

A multi-specialty and multi-society coalition developed talking points concerning the risks and benefits of using paclitaxel devices.