2014 Annual Meeting Summary
Antonios Gasparis, MD
2014 Annual Program Committee Chair
The 26th Annual Meeting of the American Venous Forum (AVF) was held at The Roosevelt on February 19-21, 2014, in New Orleans, Louisiana where a record attendance occurred with over 700 participants. This is the same city where the first AVF Annual Meeting took place.
The meeting kicked off on Wednesday morning, February 19, with the David S. Sumner Venous Summit. The program, titled When Things Go Wrong – A Rare Case of Mismanagement, was chaired by Dr. Fedor Lurie and featured presentations by 11 esteemed faculty. The presentations focused on some of the undesirable outcomes that arise from variability in patient care patterns and quality in the expanding world of venous health care. Topics included complexity of patient care and optimal settings; controversies and paradigms in managing chronic venous disease, venous reflux, EHIT, and pulmonary embolism; post-treatment management of superficial vein procedures, venous ablations and post-thrombotic syndrome; and various aspects of “when things go wrong,” including ethical and legal aspects, insurance, and the role of professional societies.
Following the David S. Sumner Venous Summit, the general session began with a welcome from Drs. Peter Henke and Antonios Gasparis, AVF President and Annual Program Committee Chair, respectively. The topic of Scientific Session 1 was superficial vein disease, and included talks on development of a disease-specific patient assessment tool, phlebectomy, endovenous laser ablation, microfoam treatment of varicose veins, and venous reflux. This session also featured four quick-shot presentations. The day continued with Scientific Session 2 on chronic venous obstructions. This was a stimulating session featuring presentations on venous stents, chronic venous obstructions, iliac vein obstruction, balloon angioplasty and intimal hyperplasia. Wednesday concluded with a Welcome Reception in the exhibit hall.
Thursday began with two special breakfast sessions hosted by the AVF. The New Member Breakfast with the Board welcomed all new AVF members who joined the association in 2013 and early 2014, and offered them a chance to become acquainted with current AVF leadership. The Intro to AVF Guest Breakfast was hosted by the AVF Membership Committee and all non-member meeting attendees were invited.
The program on Thursday started with Scientific Session 3 which focused on venous thromboembolism and IVC filters, deep vein thrombosis, and catheter-directed thrombolysis. Two of the presentations in session 3 were given by the 2014 winners of the Servier Traveling Fellowship. This was followed by the ACP Symposium which focused on The Evaluation and Treatment of Non-Truncal Varicose Veins of the Lower Extremities. The ACP Symposium was chaired by Mark Forrestal, MD and featured five additional speakers from the American College of Phlebology- Diana Neuhardt, RVT, Carl Black, MD, Marlin Schul, MD, Nick Morrison, MD, and Lisa Pavone, MD. The afternoon continued with the Villavicencio Symposium – Acute venous Thromboembolism: A Focus on Acute PE, chaired by Dr. Victor Tapson. The Villavicencio Symposium focused on treatment of acute VTE, with emphasis on pulmonary embolism. Treatments discussed include anticoagulants and low molecular weight heparins, catheter-directed thrombolytic therapy, vena cava filters, acute embolectomy and other novel therapeutic maneuvers being increasingly utilized for patients with more extensive emboli. Additional speakers included Tod Englehardt, MD and Anthony Comerota, MD. Scientific Session 4 on chronic venous obstructions included discussion on venous stenting in the elderly, compression, study of venous anatomy in human embryos, recanalization and neovascularization after DVT, and muscle oxygenation during exercises after DVT. This was followed by the Best Paper Session, featuring top abstracts from the European Venous Forum, the American College of Phlebology, and the Royal Society of Medicine. The European Venous Forum had two speakers; Katy Darvall, MBChB, MRCS who spoke about long-term clinical effectiveness of ultrasound-guided foam sclerotherapy for varicose veins; and Christos Karathanos, MD who presented on factors associated with the development of superficial vein thrombosis in patients with varicose veins. Caroline Fife, MD presented the best paper from the American College of Phlebology on real time visualization of lymphatic dysfunction in venous ulcer patients and the effect of pneumatic compression. From the Royal Society of Medicine, Oliver Lyons, MD discussed genetic patterning of development, control and maintenance of venous valves.
The American Venous Forum was honored to welcome keynote speaker Alberto Smith, PhD of Kings College London to present the D. Eugene Strandness Memorial Lecture entitled Insights into Mechanisms That Regulate the Resolution of Venous Thrombi. Alberto Smith is a Professor of Vascular Science and Head of the Academic Department of Surgery at King’s College London. His research centers around the regulation of tissue remodeling in vascular diseases, particularly venous disease. The emphasis of his research is on the elucidating mechanisms that regulate thrombus resolution and the development and maintenance of venous valves. This work is carried out using both models of disease and studies in man, and is facilitated by biochemical, histological, genetic and novel imaging techniques. He is a founding member of the European Vascular Biology Organization and is the non-clinical member of the Vascular Society of Great Britain & Ireland Research Committee. The Strandness Memorial Lecture was followed by twenty poster presentations, delivered to the entire general session room using digital displays. The Poster Reception followed immediately after the Poster Presentations in the Poster Hall, which had sixty Poster Displays on exhibit Wednesday through Friday.
Friday morning began bright and early with a symposium by the International Union of Phlebology, chaired by Nick Morrison, MD and Angelo Scuderi, MD. The UIP Symposium, titled Guidelines and Consensus of UIP, featured talks by Armando Schapira, MD, Eduardo Tkach, MD, Attilio Cavezzi, MD, Pier Luigi Antignani, MD, Malay Patel, MD, Philip Coleridge-Smith, DM FRCS, and Kurosh Parsi, MD. Discussions included a summary of UIP’s last consensus, guidelines on diagnosis of lymphedema, venous hemodynamics, a UIP consensus on foam sclerotherapy, and guidelines on diagnosis of vascular malformations. The UIP Symposium was followed by Scientific Session 5 on superficial vein disease. Topics included vein closure rates for ultrasound guided foam sclerotherapy and endovenous microfoam treatment, use of a novel biodegradable implant to treat reflux, a clinical trial comparing endovenous laser ablation and surgery for treating small saphenous insufficiency, a study of the availability of varicose vein treatments on the internet, and metabolic profiling of chronic venous ulceration.
The President’s Session opened with reports from our two Servier Traveling Fellowship winners from 2013, Andrea Obi, MD and Carson Oostra, MD, who presented their research at the European Venous Forum Annual Meeting in Belgrade, Serbia. The Servier Traveling Fellowship provides travel expenses to the award winner and is sponsored by Servier Laboratories. The next presentation was the 2013 BSN Jobst Research Grant recipient, Xabia Caliste, MD. Dr. Caliste presented on her research project on venous thromboembolism following trauma or surgery. Jose Almeida, MD gave an update on the progress of the Vascular Quality Initiative, a collaborative project of SVS and AVF. President of the AVF Foundation, Peter J. Pappas, MD, gave an update on the 2013 developments of the Foundation. The Foundation update was followed by two memorial tributes to AVF Founding Members who have recently passed away. A tribute for Dr. James DeWeese was presented by John Blebea, MD who studied under Dr. DeWeese and a tribute for Dr. David S. Sumner was presented by Robert McLafferty, MD. The chairman of the AVF Membership Committee, Jose Almeida, MD, spoke about the Committee’s three year plan to grow AVF membership.
The 2013 AVF President-Elect, Fedor Lurie, MD, gave the Presidential Address Introduction, citing facts and anecdotes about Peter Henke, MD. The Presidential address was delivered by 2013-2014 AVF President, Peter K. Henke, MD. He expressed gratitude and appreciation of the many people who have offered him support throughout his life, career and presidency with AVF. He spoke of the accomplishments of AVF during his year as President and the direction the association is going as he succeeds to Past President. The President’s Session was followed by the Annual AVF Member Business Luncheon.
Friday afternoon continued with Scientific Session 6, a mix of venous topics including metabolic phenotype of varicose veins, morphological changes in a vein after radiofrequency ablation, baboon model study of venous thrombosis, a study of pro-thrombotic biomarkers to detect risk of thrombosis, venous therapy for autonomic dysfunction, and a bioprosthetic bicuspid venous valve. Session 6 was followed by the Specialty Symposia Sessions. The 26th Annual Meeting expanded the Specialty Symposia again, this year featuring six different Symposia split into two sessions. Specialty Symposium A: Deep Venous Disease, chaired by Suresh Vedantham, MD included speakers Akhilesh Sista, MD, Suman Rathbun, MD, and Elna Masuda, MD. Specialty Symposium B/F: Vascular Medicine & Thrombosis was chaired by Thom Rooke, MD and included speakers Steven Dean, MD and Theresa Carman, MD. Specialty Symposium C/G: Wound Care, Lymphedema & Compression was chaired by Colleen Moore, MD and included speakers Kathleen Ozsvath, MD, Audra Duncan, MD, and Manju Kalra, MD. Specialty Symposium D: Animal Models in Venous Research was chaired by Jose Antonio Diaz, MD and included speakers Thomas Wakefield, MD, Prakash Saha, MD, Daniel Myers, PhD, and Joseph Raffetto, MD. Specialty Session E: Superficial Veins Done Differently was chaired by Steven Elias, MD and included speakers Ellen Dillavou, MD, Peter J. Pappas, MD, and Jennifer Heller, MD. Specialty Symposium H: Biomechanics of Venous Valves: In Silico, In Vitro and In Vivo was chaired by Ghassan Kassab, MD and Fedor Lurie, MD and included speakers Seshadri Raju, MD, Fedor Lurie, MD, Michael Sacks, MD, Antonio Rosales, MD and Zachary Berwick, MD.
The 26th Annual Meeting concluded Friday evening with the Mardi Gras Soirée. The event opened with an awards ceremony given by Dr. Peter Henke, who presented the following awards: the prestigious Founder’s Award was given to Lazar J. Greenfield, MD; The Best Paper Award went to Muzaffar Anwar, MBBS, MRCS; the Best Poster was awarded to Katherine Gallagher, MD; the two winners of the Servier Traveling Fellowship were Adam Ring, MD and Rafael Malgor, MD; and the recipient of the 2014 BSN Jobst Research Grant of $50,000 was Harry Ma, MD from University of Oklahoma. After awards were announced, the festively costumed attendees enjoyed New Orleans cuisine and music from a live New Orleans jazz band.