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Venous Thrombosis III: Interprofessional Care01:29

Venous Thrombosis III: Interprofessional Care

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Venous thrombosis requires effective prevention and treatment strategies to improve patient outcomes and reduce potential complications.Prevention StrategiesHealthcare providers must prioritize preventing venous thromboembolism (VTE) for all adult patients upon admission. Interventions depend on bleeding and thrombosis risk, medical history, current medications, diagnoses, planned procedures, and patient preferences. Patients on bed rest should change positions every two hours and, if not...
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Varicose Veins II: Diagnostic Studies and Interprofessional Care01:26

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Varicose veins, or varicosities, develop when the valves in the veins, which control blood flow, weaken or damage. It causes blood to pool and the veins to enlarge. Understanding the clinical manifestations, diagnostic approaches, and management options for varicose veins is crucial for effective treatment and relief.Clinical manifestationsClinical manifestations of varicose veins include a heavy, achy feeling or pain after prolonged standing or sitting. This discomfort can often be relieved by...
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Venous Thrombosis II: Clinical Manifestations and Diagnostic Studies01:20

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The key difference between Superficial Vein Thrombosis (SVT) and Deep Vein Thrombosis (DVT) lies in their location and severity.Clinical ManifestationsSVT typically presents with localized pain, tenderness, and redness along the course of a superficial vein, often accompanied by a palpable, cord-like structure under the skin. This condition is usually less dangerous than DVT but can be uncomfortable and may lead to complications such as cellulitis or, rarely, a clot extension into the deep...
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Nursing management begins with a thorough assessment of the patient's health history. Key factors include trauma to veins, peripherally inserted central catheters, varicose veins, recent pregnancy or childbirth, surgery, bacteremia, prolonged bed rest, atrial fibrillation, COPD, heart failure, cancer, coagulation disorders, myocardial infarction, spinal cord injury, stroke, prolonged travel, recent bone fractures, and dehydration. Review medication intake, particularly oral contraceptives,...
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Pulmonary Embolism II: Diagnostic Studies and Interprofessional Care01:29

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Diagnosing Pulmonary EmbolismDiagnosing pulmonary embolism (PE) involves clinical assessment and advanced imaging tests. The preferred diagnostic tool is the spiral (helical) CT scan or CT angiography (CTA), which uses intravenous contrast media to visualize the pulmonary vasculature and identify emboli.A ventilation-perfusion (V/Q) scan is an alternative for patients unable to receive contrast media. This scan includes both perfusion and ventilation scanning. Perfusion scanning involves...
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Venous Thrombosis I: Introduction01:30

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Venous thrombosis, the most common disorder of the veins, involves the formation of a thrombus or blood clot associated with vein inflammation. It can be classified as either superficial vein thrombosis or deep vein thrombosis.Superficial Vein Thrombosis: This involves the formation of a thrombus in a superficial vein, usually the greater or lesser saphenous vein. Though less severe than deep vein thrombosis (DVT), SVT can lead to complications if untreated.Deep Vein Thrombosis (DVT): This...
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Delphi consensus on diagnostic and therapeutic pathways for pelvic venous disorders - A multidisciplinary algorithm.

Domenico Baccellieri1, Antonio Basile2, Alessandro Arena3

  • 1Department of Vascular Surgery, Vita-Salute University School of Medicine, San Raffaele Scientific Institute, Milan, Italy.

VASA. Zeitschrift Fur Gefasskrankheiten
|March 5, 2026
PubMed
Summary

Experts developed a diagnostic and therapeutic algorithm for pelvic venous disorders (PeVD), classifying them into Pelvic Congestion Syndrome and obstructive syndromes. Endovascular therapy is the standard of care for PeVD management.

Keywords:
chronic pelvic paindelphi consensusdiagnostic algorithmendovascular treatmentpelvic congestion syndromepelvic venous disorders

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Area of Science:

  • Vascular Medicine
  • Interventional Radiology
  • Gynecologic Surgery

Background:

  • Pelvic venous disorders (PeVD) cause chronic pelvic pain and varicose veins due to pelvic venous insufficiency.
  • Lack of standardized diagnostic criteria complicates PeVD management.
  • Expert consensus is needed to establish reliable diagnostic and therapeutic pathways.

Purpose of the Study:

  • To develop and validate a multidisciplinary diagnostic and therapeutic algorithm for PeVD.
  • To establish consensus among specialists on PeVD classification and treatment strategies.

Main Methods:

  • Convened an Advisory Board of 11 Italian specialists (gynecologists, radiologists, vascular surgeons, angiologists).
  • Developed a draft algorithm informed by literature review.
  • Conducted three Delphi survey rounds with a ≥70% consensus threshold.

Main Results:

  • Classified PeVD into Pelvic Congestion Syndrome (PCS) and compressive/obstructive syndromes.
  • Endovascular therapy (embolization for PCS, stenting for obstruction) is the standard of care.
  • Clinical success defined as symptom improvement at 3-6 months; surgery reserved for failed conservative/endovascular options.

Conclusions:

  • A validated, multidisciplinary algorithm for PeVD diagnosis and treatment was established via Delphi consensus.
  • The algorithm emphasizes standardized clinical pathways for PeVD.
  • Further validation by a broader expert community is recommended.