Results of the National Pilot Screening Program for Venous Disease by the American Venous Forum

• Published in: Journal of vascular surgery 2007, Vol.45 (1), p.142-148.e4
• Main Authors: McLafferty, Robert B., MD, Lohr, Joanne M., MD, Caprini, Joseph A., MD, Passman, Marc A., MD, Padberg, Frank T., MD, Rooke, Thom W., MD, Bush, Ruth L., MD, MPH, Zakaria, Aamir A., MD, Flinn, William R., MD, Eklof, Bo G., MD, Dalsing, Michael C., MD, Markwell, Steven J., MS, Wakefield, Thomas W., MD
• Format: Article
• Language: English
• Subjects: Adult; Aged; Aged, 80 and over; Biological and medical sciences; Cardiovascular system; Female; Humans; Incidence; Investigative techniques, diagnostic techniques (general aspects); Male; Mass Screening - methods; Medical sciences; Middle Aged; Pharmacology. Drug treatments; Pilot Projects; Radionuclide investigations; Retrospective Studies; Societies, Medical; Surgery; Surgery (general aspects). Transplantations, organ and tissue grafts. Graft diseases; Surveys and Questionnaires; Ultrasonography, Doppler, Duplex; United States - epidemiology; Vascular surgery: aorta, extremities, vena cava. Surgery of the lymphatic vessels; Vascular wall; Venous Insufficiency - diagnosis; Venous Insufficiency - epidemiology; Venous Thrombosis - diagnosis; Venous Thrombosis - epidemiology
• ISSN: 0741-5214; 1097-6809
• DOI: 10.1016/j.jvs.2006.08.079

Objective This report describes the pilot of a free comprehensive national screening program for venous disease. Methods The screening process consisted of a venous thromboembolism (VTE) risk assessment, abbreviated duplex examination for venous obstruction and reflux, inspection for signs of chronic venous insufficiency (CVI), and an exit interview. Physicians coordinating the screenings were members of the American Venous Forum. Results Seventeen institutions screened 476 people (mean, 28 per site; range, 6 to 71). Mean age was 60 years (range, 40 to 91 years), with 78% women and 68% with a body mass index of ≥25. If placed in a situation conducive for VTE, 22 participants (5%) were low risk, 87 (18%) were moderate risk, 186 (39%) were high risk, and 179 (38%) were at very high risk. In 26 people (6%), one or more segments had venous obstruction, and 190 (40%) had one or more segments of venous reflux in the lower extremities. Varicose veins were present in 32%, edema without skin changes in 11%, skin changes attributable to venous disease in 8%, and healed or active venous stasis ulcer in 1.3% (CEAP classification 2, 3, 4, 5, and 6, respectively). Increasing age and increasing deep venous thrombosis risk score significantly correlated with increasing clinical classification, r = 0.09, P = .04, and r = 0.16, P = .0004, respectively. Those participants with reflux in one or more segments were significantly more likely to have a higher clinical classification compared with those with no reflux ( P = .0001). Conclusion The first comprehensive national screening for venous disease was performed. Participants were informed of their risk for VTE if placed in a situation conducive to VTE, screened for evidence of obstruction, reflux, and CVI, and empowered to share their results with their primary care provider.