Conversation in Interventional Cardiology: SCAI Clinical Practice Guidelines for the Management of Chronic Venous Disease-CVD Guidelines Manuscript PDF

CVD Guidelines Manuscript PDF

Pdf Summary

The 2025 SCAI Clinical Practice Guidelines, endorsed by the Society for Vascular Medicine, provide evidence-based recommendations for the management of chronic venous disease (CVD). Addressing a common vascular condition affecting over 25 million U.S. adults, CVD symptoms include leg discomfort, heaviness, and ulceration, which significantly impact quality of life. The guidelines aim to support treatment decisions with a comprehensive approach comprising compression therapy, ablation, sclerotherapy, phlebectomy, venoplasty, and stenting.<br /><br />These guidelines result from systematic evidence reviews using the GRADE methodology, assessing the certainty of evidence to formulate strong or conditional recommendations. For patients with symptomatic varicose veins, compression therapy is suggested, whereas it is strongly recommended for venous ulcers due to its effectiveness in improving healing rates. Additionally, ablation therapy, particularly for the great saphenous vein (GSV) and perforator veins, is suggested under specific conditions because of the potential for improved symptoms and ulcer healing, despite limited evidence. <br /><br />Sclerotherapy combined with conservative management is conditionally recommended for symptomatic varicose veins without truncal vein reflux and venous ulcers. Although phlebectomy is conditionally supported for varicose veins without sufficient direct evidence, it is not recommended for ulcer management due to knowledge gaps. <br /><br />For cases with iliocaval venous stenosis, venoplasty or stenting alongside conservative management is advised for symptom improvement in selected patients. However, no recommendations are made for femoral venous disease due to insufficient evidence, highlighting a need for further research.<br /><br />These guidelines underscore the importance of tailoring treatments to individual patient circumstances, emphasizing shared decision-making, and recognizing ongoing research needs to address identified knowledge gaps for comprehensive CVD management.

Keywords

SCAI Clinical Practice Guidelines

chronic venous disease

vascular condition

compression therapy

ablation

sclerotherapy

phlebectomy

venoplasty

stenting

GRADE methodology