The Sixth Pacific Vascular Symposium

Abstract

Chronic venous disease (CVD) is a common problem worldwide and is primarily related to venous insufficiency of the lower extremity veins. The etiology may be primary, due to venous valvular incompetence; or secondary, due to post deep vein thrombosis (DVT) vein wall damage. The clinical presentation includes leg swelling, pain, lipodermatosclerosis, hyperpigmentation, and venous stasis ulcers (VSUs) (found in the most severe cases). This affects 2.5 million patients per year in the United States and is estimated to cost more than $3 billion per year.1,2 The acute ulcers are problematic and require prolonged medical and surgical care; the recurrence rate of VSUs may be as high as 70%.3 Lack of disease understanding, lack of physician interest, and diffusion of patient care across multiple specialties all contribute to lack of CVD progress. In addition to a thorough medical history and physical examination, standard diagnostic testing for those who present with a VSU should include venous duplex ultrasonography. This yields information about luminal obstruction (post DVT), valvular competence, and whether the insufficiency affects the superficial, deep, or both vein systems anatomically. Similarly, an ideal biomarker would prognosticate patients with mild CVD, either primary or secondary, to either high or low risk of VSU and would be useful for guiding therapeutic interventions. Although several biomarkers, such as intercellular adhesion molecule-1, interleukin 6, and C-reactive protein, have shown some correlation with CVD severity, none are robust enough to use routinely at this point. The Sixth Pacific Vascular Symposium was conducted under the auspices of …