EUViC , August 2024, India Highlights .pptx

Highlights of endovascukar workshop which I attend @ India in August 2024

1. Highlights of EUViC 2024 Rohan Jayawardena Senior Registrar in Vascular & Transplant Surgery Teaching Hospital Karapitiya

2. About EVLT Concept of Crossectomy

3. GSV tributaries Anterior & posterior Accessory GSV veins Superficial External Pudendal Superficial Inferior Epigastric Superficial Circumflex Illiac

4. Anterior accessory vein

5. Tumescent anesthesia 500 ml of RL 15 ml of Lignocaine

6. Sclerotherapy Indications – All types of veins Absolute C/I – Allergy Acute DVT Local infections Long standing immobility & confinement to bed Foam – symptomatic patent foramen ovale

7. Sclerotherapy Relative C/I – Pregnancy BF Severe PVD High thromboembolic risk Acute superficial venous thrombosis Foam – neurological disturbance following previous foam therapy Lipodermatosclrosis ??????

8. Sclerotherapy Telangiectasia – 0.1% STS (Sodium Tetradecyl Sulfate) Reticular veins – 0.5% STS Tributaries/Perforators/Recurrent VV – Foam with 1.5 – 3% STS Saphenous trunk – 1- 3% Volumes – do not exceed 4 – 10 ml for saphenous trunks Time of contact – 5 – 10 min in a lying position

9. Sclerotherapy Anticoagulation – Previous DVT, Thrombophilia Duplex – D7, D30, D360 Compression – Eccentric compression on tributaries Day & night for the 1 st 24 hours Daily wearing for 1 week

10. Management of an Ulcer Ulcer Assessment – ABPI/VD Vascular Pathology(80%) Non Vascular Pathology Venous Arterial Necrotic Angio dermatitis Compression Revas SSG Biopsy

11. Management of Venous Ulcer Washing – Just to remove excess exudate Dressings – Hydrocolloid/ Vaseline Compression Venous interventions Physiotherapy Re-evaluation – at 4 weeks – Compliance/Size of the ulcer/ Wrong diagnosis

12. Management of Lymphoedema Intermittent pneumatic compression Compression Massaging Physiotheraphy

13. Wraps

14. Wraps

15. When to investigate deep veins ? Advanced venous disease – C3 – C6 Intractable ulceration Recurrent failure of endovenous therapy Investigation – VD, MRI/CT Venography

16. Treatment Deep venous disease Pure Obstruction Mixed Pure Reflux Venoplasty+Stent Compression Venous bypass

17. MPFF – Micronized Purified Flavonoid Fraction ( Daflon ) Pain Feeling of swelling Functional discomfort Cramps Reduce Leg redness Skin changes Oedema QOL - improve

18. MPFF – Micronized Purified Flavonoid Fraction ( Daflon ) Dose – 500 mg bd Recommendation – 2 weeks prior to RFA/EVLT - 4 weeks post intervention

19. MPFF – Micronized Purified Flavonoid Fraction ( Daflon )

20. Thank you