AVF Day 3: Superficial and Deep Venous Treatment Advances

Assessing and Treating Venous Obstruction

A review of hemodynamic tests for iliofemoral obstruction found none reliably determines severity or predicts stenting response. A companion talk described persistent stent occlusion, difficult crossing of occluded stents, and migration, mostly tied to technique rather than device design.

Emerging Medical and Procedural Therapies

Sulodexide with rivaroxaban improved leg circumference and quality of life after acute deep vein thrombosis through endothelial glycocalyx repair. An early trial of perivenous dexamethasone after thrombectomy showed favorable biomarker and Villalta score trends for preventing post thrombotic syndrome.

Ablation Technique and Safety

Studies reported strong redo thermal ablation outcomes for the accessory saphenous vein, one year mechanochemical ablation results, a rapid multi-segment cyanoacrylate technique, and hypersensitivity risk factors including younger age, female sex, and longer treated vein length.

Complex and Combined Disease

Renal vein decompression with renal artery denervation improved pain and quality of life in Nutcracker syndrome. A closing case discussion recommended treating both superficial and deep venous disease in patients with chronic venous ulcers rather than superficial ablation alone.