In this podcast, Dr. Nedaa Skeik, a vascular surgeon with Minneapolis Heart Institute, brings his knowledge and experience in regards to vascular insufficiency, and the importance of a timely diagnosis and management options.

*Disclosure note: Dr. Nedaa Skeik, speaker for this educational event, has disclosed that he received honorarium from Medtronic. All relevant financial relationships for Dr. Skeik have been mitigated.

Enjoy the podcast.

Objectives:Upon completion of this podcast, participants should be able to:

• Summarize the pathophysiology of different venous disorders.
• Recognize and confidently diagnose venous insufficiency.
• Identify the risks and benefits of different interventions for venous conditions.
• Differentiate medical management (conservative and interventional) for venous insufficiency.

This activity has been planned and implemented in accordance with the accreditation criteria, standards and policies of the Minnesota Medical Association (MMA). Ridgeview is accredited by the Minnesota Medical Association (MMA) to provide continuing medical education for physicians.

CME credit is only offered to Ridgeview Providers & Allied Health staff for this podcast activity. After listening to the podcast, complete and submit the online evaluation form. Upon successful completion of the evaluation, you will be e-mailed a certificate of completion within approximately 2 weeks. You may contact the accredited provider with questions regarding this program at [email protected].

Click the link below, to complete the activity's evaluation.

CME Evaluation

(**If you are listening to the podcasts through iTunes on your laptop or desktop, it is not possible to link directly with the CME Evaluation for unclear reasons. We are trying to remedy this. You can, however, link to the survey through the Podcasts app on your Apple and other smart devices, as well as through Spotify, Stitcher and other podcast directory apps and on your computer browser at these websites. We apologize for the inconvenience.) DISCLOSURE ANNOUNCEMENT

The information provided through this and all Ridgeview podcasts as well as any and all accompanying files, images, videos and documents is/are for CME/CE and other institutional learning and communication purposes only and is/are not meant to substitute for the independent medical judgment of a physician, healthcare provider or other healthcare personnel relative to diagnostic and treatment options of a specific patient's medical condition; and are property/rights of Ridgeview. Any re-reproduction of any of the materials presented would be infringement of copyright laws.

It is Ridgeview's intent that any potential conflict should be identified openly so that the listeners may form their own judgments about the presentation with the full disclosure of the facts. It is not assumed any potential conflicts will have an adverse impact on these presentations. It remains for the audience to determine whether the speaker’s outside interest may reflect a possible bias, either the exposition or the conclusions presented.

None of Ridgeview's CME planning committee members have relevant financial relationship(s) to disclose with ineligible companies whose primary business is producing, marketing, selling, re-selling, or distributing healthcare products used by or on patients. All of the relevant financial relationships for the individuals listed above have been mitigated.

Thank-you for listening to the podcast.

SHOW NOTES: *See the attachment for additional information.

PODCAST OVERVIEW

Wide Range of Venous Disorders and Presentations - Morphologic (spider, reticular, varicose), skin discoloration, ulceration - Functional (venous reflux +/- loss of pumping mechanism - Anatomic (thrombosis, congenital anomalies) - Presentation (asymptomatic vs symptomatic)Anatomy PathophysiologyEpidemiology - Chronic vein abnormalities- Prevalence (venous insufficiency) - Varicose veins & prevalence- Presence of symptoms Risk factors - Family component- Other Clinical features - Correlation - severity of venous reflux, age- Asymptomatic - General symptoms - Vein appearance - Severity Disease Severity - Classification Scales - CEAP calssification scale- Venous Clinial Severity Score Disease Progression - Correlation- pregression of disease not well understoodDiagnosis - History - Symptoms - Exam findings - including venous ultrasound - Differential diagnoses (edema, skin manifestations, vein engorgement) - Pre-management considerations (severity, superficial and/or deep, proximal/distal, multiple or single, comorbidities) ManagementAsymptomatic - visual sclerotherapy- surface laser therapy - complications Symptomatic- compression therapy - exercise - leg elevation - skin care Conserative Therapy- leg elevation - exercise - compression stockings Pharmacologic Therapy and Skin Care- vasoactive drugs - rheologic agents - skin care Interventional Options - Preintervention measures (venous anatomy, preop medications, anesthesia) - Sclerotherapy (visual, US guided)- Vein closure procedures (thermal - RFA/EVLA, chemical, MOCA, PEM, EHIT) - Surgical (phlebectomy, ligation, stripping) Post Intervention Care - pain management - ambulation - leg elevation - compression - return to normal activity/work - post procedural US - follow up appointment

Thanks to Dr. Nedaa Skeik for his expert knowledge and contribution to this podcast.

Please check out the additional show notes for more information/resources.