SVU 2025 Annual Conference Friday Venous Session-SVU 2025 Annual Conference Friday Venous Session

Video Transcription

Video Summary

The Venus session covered extensive topics on venous diseases and lymphatic microsurgery. Initially, Donna Kelly discussed pelvic venous disorders, emphasizing complex pelvic vein anatomy, including left renal, gonadal, and iliac veins. She stressed ultrasound protocols using curvilinear and linear probes, patient positioning, and Doppler settings for diagnosing stenosis or reflux. Diagnostic criteria for vein diameters and velocity ratios were detailed, with attention to anatomical variations and compression syndromes like May-Thurner. <br /><br />Jeannie White-Melendez elaborated on the significance of fascia in venous anatomy, clarifying updated consensus terminology and its role in vein identification and protection. She highlighted the interfascial paths of saphenous veins, anatomical variations, and the official renaming of the anterior accessory great saphenous vein to anterior saphenous vein (May 2024), impacting procedural targeting and ultrasound assessments.<br /><br />Donna then addressed non-saphenous reflux in the lower extremity, covering causes like perforator veins, neovascularization post-procedures, and pelvic-origin varicosities through escape points. She emphasized mapping varicose veins to their sources for appropriate treatment.<br /><br />Brian Sapp argued for essential post-intervention follow-up ultrasounds, countering recent guidelines and highlighting increased thrombotic risks post-COVID-19, importance of detecting EHIT/DVT early, documenting residual reflux, and guiding secondary treatments. He stressed thorough comprehensive duplex ultrasounds over minimal checks to improve outcomes.<br /><br />Finally, Dr. Chen presented cutting-edge lymphatic supermicrosurgery, revealing that lymphedema is systemic and linked to cognitive impairments. He introduced brain lymphatics (glymphatics and meningeal lymphatics), their role in neurodegenerative diseases like Alzheimer’s, and pioneering extracranial surgeries (lymphatic-venular and lymph node-to-vein anastomosis) aiming to treat these conditions. Ultrasound aids precise mapping of lymphatics and nodes for minimally invasive, robotic-assisted procedures. Early clinical and animal data show promising cognitive improvements, opening possibilities for broader neurological disease treatments.

Keywords

Venous diseases

Lymphatic microsurgery

Pelvic venous disorders

Pelvic vein anatomy

Ultrasound protocols

Doppler settings

Vein stenosis diagnosis

May-Thurner syndrome

Fascia in venous anatomy

Anterior saphenous vein renaming

Non-saphenous reflux

Post-intervention ultrasound follow-up

Thrombotic risks post-COVID-19

Lymphatic supermicrosurgery

Neurodegenerative disease treatment