Journal of Vascular Surgery
Volume 45, Issue 1 , Pages 142-148.e4, January 2007

Results of the National Pilot Screening Program for Venous Disease by the American Venous Forum

Presented at the Eighteenth Annual Meeting of the American Venous Forum, Miami, Fla, Feb 23, 2006.

  • Robert B. McLafferty, MD

      Affiliations

    • Southern Illinois University, Springfield, Ill
    • Corresponding Author InformationReprint requests: Robert B. McLafferty, MD, Professor of Surgery, Southern Illinois University PO Box 19638, Springfield, Il 62794-9638.
    • ,
  • Joanne M. Lohr, MD

      Affiliations

    • Lohr Surgical Specialists, Cincinnati, Ohio
    • ,
  • Joseph A. Caprini, MD

      Affiliations

    • Northwestern University, Evanston, Ill
    • ,
  • Marc A. Passman, MD

      Affiliations

    • Vanderbilt University, Nashville, Tenn
    • ,
  • Frank T. Padberg, MD

      Affiliations

    • UMDJ-New Jersey Medical School, Newark, NJ
    • ,
  • Thom W. Rooke, MD

      Affiliations

    • Mayo Clinic, Rochester, Minn
    • ,
  • Ruth L. Bush, MD, MPH

      Affiliations

    • Baylor College of Medicine, Houston, Tex
    • ,
  • Aamir A. Zakaria, MD

      Affiliations

    • Southern Illinois University, Springfield, Ill
    • ,
  • William R. Flinn, MD

      Affiliations

    • University of Maryland, Baltimore, Md
    • ,
  • Bo G. Eklof, MD

      Affiliations

    • Helsingborg, Sweden
    • ,
  • Michael C. Dalsing, MD

      Affiliations

    • Indiana University, Indianapolis, Ind
    • ,
  • Steven J. Markwell, MS

      Affiliations

    • Southern Illinois University, Springfield, Ill
    • ,
  • Thomas W. Wakefield, MD

      Affiliations

    • University of Michigan, Ann Arbor, Mich.

Received 17 April 2006; accepted 28 August 2006.

Objective

This report describes the pilot of a free comprehensive national screening program for venous disease.

Methods

The screening process consisted of a venous thromboembolism (VTE) risk assessment, abbreviated duplex examination for venous obstruction and reflux, inspection for signs of chronic venous insufficiency (CVI), and an exit interview. Physicians coordinating the screenings were members of the American Venous Forum.

Results

Seventeen institutions screened 476 people (mean, 28 per site; range, 6 to 71). Mean age was 60 years (range, 40 to 91 years), with 78% women and 68% with a body mass index of ≥25. If placed in a situation conducive for VTE, 22 participants (5%) were low risk, 87 (18%) were moderate risk, 186 (39%) were high risk, and 179 (38%) were at very high risk. In 26 people (6%), one or more segments had venous obstruction, and 190 (40%) had one or more segments of venous reflux in the lower extremities. Varicose veins were present in 32%, edema without skin changes in 11%, skin changes attributable to venous disease in 8%, and healed or active venous stasis ulcer in 1.3% (CEAP classification 2, 3, 4, 5, and 6, respectively). Increasing age and increasing deep venous thrombosis risk score significantly correlated with increasing clinical classification, r = 0.09, P = .04, and r = 0.16, P = .0004, respectively. Those participants with reflux in one or more segments were significantly more likely to have a higher clinical classification compared with those with no reflux (P = .0001).

Conclusion

The first comprehensive national screening for venous disease was performed. Participants were informed of their risk for VTE if placed in a situation conducive to VTE, screened for evidence of obstruction, reflux, and CVI, and empowered to share their results with their primary care provider.

 

 Competition of interest: The National Pilot Screening Program for Venous Disease was made possible from a grant to the American Venous Forum from the Juzo Company.

 Additional material for this article may be found online at www.jvascsurg.org.

PII: S0741-5214(06)01617-X

doi:10.1016/j.jvs.2006.08.079

Journal of Vascular Surgery
Volume 45, Issue 1 , Pages 142-148.e4, January 2007

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