AVF/SVM/EVF Joint Session: Perforators, SVT, Stents, and Valves

Perforator Vein Glue Closure and Superficial Vein Thrombosis

Ultrasound-guided cyanoacrylate closure of incompetent perforator veins achieved an 86.7% closure rate across a thousand-plus veins with no thromboembolic complications, outperforming laser. Duplex imaging is essential for superficial vein thrombosis, since thrombus can extend into the deep system.

Antithrombotic Therapy and Inflammation After Venous Stenting

Inflammation appears to drive stent thrombosis alongside flow-related causes. A randomized trial found aspirin added to rivaroxaban did not clearly improve patency after iliocaval stenting, and statins may lower post-thrombotic rates.

Obesity, Lymphedema, and Venous Disease

Obesity drives a cycle of adipose inflammation, impaired lymphatic contraction, and worsening lymphedema, termed obesity-induced lymphedema. Weight-loss drugs and bariatric surgery help but often fail to reverse lipedema, so weight management remains the mainstay.

Venous Valve Physiology and Unmet Needs in Deep Venous Surgery

Native venous valves generate helical and phasic flow that lowers thrombus risk in valve pockets, explaining why reconstructed valve trials underperformed native repair. Gaps include stenting patient selection, next-generation devices, and venous disease training.