INSIDE Medicaid work rule works for some Thank you nurses for all you do Dermaka has new enhanced formula Improved Beacon Tip catheters back
JUNE/JULY 2018 Vol. 11, No. 3 VEINTHERAPYNEWS.COM
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An ACP recognized resource for news and information for and about the phlebology community
2018 RESEARCH SUMMIT
Work begins to analyze data in rapidly expanding ACP PRO Venous Registry By Vanessa Salvia Contributing Editor
Once analyzed, the ACP can deliver the data, the questions and a grant from the ACP Foundation to fund the research.
CASE STUDY
Anticipation was high for many members of the phlebology community going into an April 21 closed-door research summit held alongside the International Vein Congress in Miami, convened to discuss how to make the most of the American College of Phlebology’s Patient Recorded Outcome Venous Registry, or PRO Venous Registry. This is the second annual research summit. The first one on April 21, 2017, brought together American College of Phlebology (ACP) leadership and other industry and registry thought leaders for an open discussion about the data captured by the ACP PRO Venous Registry and the immediate needs of the medical community and items that can be addressed using the database. The registry, which was first envisioned in 2009 by Marlin Schul, MD, a specialist in venous and lymphatic medicine in Lafayette, Ind., currently has 109 physicians participating. Most submit their data through an electronic medical records process, but a few participate using manual entry. There are more than 36,000 individual patients and more than 150,000 patient records to date. With more than 640
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data fields covering aspects of deep and superficial venous disease and lymphatic disease, the ACP PRO Venous Registry comprehensively represents the practice of vein and lymphatic care. Soon, the 67 vein centers owned by Vein Clinics of America and the 70 centers owned by the Centers for Vein Restoration will also begin importing their data on a weekly basis into the PRO Venous Registry. As the ACP advances on its “New Horizon” campaign to embrace advocacy, education and research, the summit brought together a committee led by seven physicians and directed by Joseph Jenkins, MD, a vein surgeon from Dubuque, Iowa, with the intention of determining how to develop quality measures for vein care along with research questions that can be asked of the data in the registry. RESEARCH SUMMIT
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Managing persistent swelling after endovenous ablation
By Tim Cawlfield, MD I have practiced phleboloby for six years and I learned early in my career that patients with swelling in the lower extremities – swelling that cannot be contained by elastic graduated compression stockings – do not benefit from endovenous ablations.
My general rule of thumb is that if a patient’s lower extremity swelling is contained with elastic compression and CVI is suspected, then endovenous ablations should significantly improve swelling in the affected leg. I have encountered only a handful of patients throughout my practicing career who have partially responded to elastic compression stockings and have fared worse after endovenous ablations. A recent example is “April,” (name changed), a 71-year-old, active female. She presented with bilateral lower extremity swelling and erythema. She was obese (BMI 32), took Synthroid for hypothyoidism, but was in otherwise good health. She had 1+ pitting edema below the left distal calf and trace pitting edema in the right ankle. There was corona phlebectatica over both medial ankles and dilated venulectasias over the left distal-medial calf.
“April” had increased swelling after endovenous ablation in her left leg without objective evidence of venous obstruction. Both calves were lightly erythematous, but without warmth or induration. There was no skin thickening or fibrosis in the lower extremities without a Stemmer’s sign. Wearing elastic graduated compression stockings partially reduced her swelling and discomfort, but she continued to have symptoms that interfered with daily activities. The duplex ultrasound of the LYMPHEDEMA
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