Villavicencio Symposium: Horizons in Venous Disease Care

Honoring Villavicencio and Superficial Disease Gaps

Moderators honored founder Lionel Villavicencio before a panel agreed varicosity and ablation treatment have improved greatly, but recurrence, often from untreated below-knee reflux or incompetent perforators, and unsatisfying spider vein results remain the biggest unmet needs.

Pelvic Venous Disorders: Awareness and Reimbursement

Panelists described low awareness of pelvic venous disorders among primary care physicians and gynecologists, often dismissed as pelvic congestion syndrome, and reimbursement barriers that ease with precise terminology and multisociety data collection.

Pelvic Venous Disorders: Staged Treatment Algorithms

For mixed reflux and obstruction, panelists generally embolize the gonadal vein and pelvic reservoir first, reserving iliac stenting for confirmed obstructive physiology or persistent symptoms, though the mix of obstructive versus refluxive disease varied across practices.

Deep Venous Disease: DVT Intervention and Valve Surgery

Panelists selectively intervene on symptomatic femoral-popliteal DVT despite the attract trial’s negative result, favor angioplasty over lytic therapy for chronic occlusion, and noted valve reconstruction remains viable mainly in focal, non-post-thrombotic reflux.