Learn the who, the when and the what of treating deep vein thrombosis

BETWEEN ADDITIONAL AVAILABLE THERAPIES, multiple new devices now on the market and evolving research supporting thrombus removal, Patrick Muck, MD, and Madhavi Meka, MD, anticipate an informative session on deep vein thrombosis (DVT) at lunchtime Wednesday.

The two surgeons will co-moderate Bringing What’s New in Deep Venous Thrombosis Treatments to You in 2023, from 12:30–1:30 p.m. in Potomac C. Box lunches will be available. The American Venous Forum (AVF) is collaborating with the SVS on both this program and Deep Venous Stenting Summit: Tips and Tricks for Success, from 1:30 to 3 p.m. Friday in the same location.

“Attendees will leave with thrombus removal strategies, coupled with several new DVT therapeutic options in their armamentariums,” said Muck. “Dr. Meka and I view this session as one to help to guide vascular surgeons on who to treat, when to treat and what device to use.”

Topics and speakers for the session include “Deep Venous Thrombosis Interventions: Who Do We Treat and Why,” with Alessandra Puggioni, MD; the many therapeutic DVT options available, presented by Angela Kokkosis, MD; tips and tricks for aggressive thrombus removal, with William Marston, MD; and “IVC (inferior vena cava) thrombosis: What works,” with Glenn R. Jacobowitz, MD.

Deep vein thrombosis is a “hot topic,” said Muck. “It’s an area of vascular surgery practice that’s growing, and it’s really an exciting session.”

Meka agreed. “There has been a paucity of literature over the past few years regarding thrombectomy/thrombolysis of large veins,” she said.

“In the past, the emphasis for treatment of acute iliac and venacaval thrombosis was on clot resolution using catheter-directed thromboslysis with percutaneous mechanical thrombectomy adjuncts such as Angiojet, EKOS and Trellis Thrombolysis systems. Prolonged infusion of lytics comes with the risk of hemorrhage, particularly intracranial. With emerging technology for enbloc clot removal (AngioVac, Inari, QuickClear, Penumbra, Jeti) infusion of lytics is becoming obsolete. The session intends to discuss some of these available techniques and gadgets.”

The presentations by Marston and Jacobowitz represent exciting topics. “There is more research now and more tools to choose from, along with information on which tool works where,” he said.—Beth Bales

SL: As I previously mentioned, I strongly believe in a partnership with a cross-specialty approach to embolization. This skill set is present in a few different specialties. The most important step is to have representation from all the specialties at the table and to formally outline areas that are treated by one specialty versus areas treated by more than one. This can also include how patients will be referred. It is also important to decide how the emergency cases will be handled and whether there should be a shared call schedule for these. This is most important in the trauma setting. This removes any confusion when referring patients and when patients need emergent treatment.

CARE DELIVERY

THE ESSENTIAL ‘NEED’ FOR VASCULAR SURGEONS IN PULMONARY EMBOLISM TREATMENT PARADIGM

VASCULAR SURGEONS WHO ARE SVS MEMBERS from pulmonary embolism response teams (PERTs) or busy PE programs at six large institutions will discuss advances in care and the role played by vascular surgeons in the current PE landscape in the VAM breakfast session, Management of Pulmonary Embolism: Fundamentals and Advances, taking place on Friday (6:45–8:00 a.m.).

The importance of a multidisciplinary team for treatment of PE patients that includes vascular surgery offers the best opportunity for improved patient outcomes, attendees will hear.

The addition of artificial intelligence (AI) in PE diagnosis, as well as the necessary role of vascular surgeons in PERT care form some of the central themes set to be discussed by Dennis R. Gable, MD, a vascular surgeon at Texas Vascular Associates in Plano, Texas. His talk will lead off the program. His talk takes place from (6:45–6:55 a.m.)

Fundamentally, Gable tells VS@VAM, venous thromboembolism (VTE), including PE, has always been considered a “peripheral vascular” diagnosis and, “we, as peripheral vascular specialists, need to be involved in this treatment paradigm and pathophysiology.”—

Bryan Kay