Management of acute and chronic iliofemoral venous outflow obstruction: a multidisciplinary team consensus
Stephen Black, Abdulrahman Alvi, Sara J. Baker, David Beckett, Karen Breen, Nicholas Burfitt, Simon Coles, Alun H. Davies, Neil H. Davies, Previn Diwakar, Anja Drebes, Kim Fortin, Manjit Gohel, Julian Hague, Christopher Hammond, Liz Haslam, Robert G. Jones, Tanya Kearney, Eldon D. Lehmann, James Lenton, Deborah Low, James C. Metcalfe, Hayley Moore, B Odedra, Shirish G. Prabhudesai, Shaun Quigley, Lakshmi Ratnam, Toby Richards, Prakash Saha, Peter Schnatterbeck, James RH Scurr, Usman Shaikh, Shoaib Shaikh, Andrew Shawyer, Richard Tippett, Sally Vrebac, Robert C. Ward, Christopher R. Watts, Andrew Wigham, Andrew P Willis, Nick Woodward, Chung Sim Lim
Abstract
The aim of this manuscript was to establish a consensus for the management of acute and chronic venous obstruction among specialists in the UK. Specialist physicians representing vascular surgery, interventional radiology and hematology were invited to 3 meetings to discuss management of acute and chronic iliofemoral obstruction. The meetings outlined controversial areas, included a topic-by-topic review; and on completion reached a consensus when greater than 80% agreement was reached on each topic. Physicians from 19 UK hospitals agreed on treatment protocols and highlighted areas that need development. Potential standard treatment algorithms were created. It was decided to establish a national registry of venous patients led by representatives from the treating multidisciplinary teams. Technical improvements have facilitated invasive treatment of patients with acute and chronic venous obstruction; however, the evidence guiding treatment is weak. Treatment should be conducted in centers with multi-disciplinary input; robust, coordinated data collection; and regular outcome analysis to ensure safe and effective treatment and a basis for future evolvement.