BackTable Vascular & Interventional Ep. 609 Chronic Venous Disease Diagnosis & Management Strategies with Dr. Steven Abramowitz
Jan 20, 2026
Dr. Steven Abramowitz, a vascular surgeon at MedStar Health, shares his expertise on chronic venous disease management. He discusses the importance of classification systems like CEAP and VCSS, targeted patient history, and innovative imaging strategies. Abramowitz emphasizes proactive prevention of post-thrombotic syndrome and various therapeutic options, including stenting techniques. He also delves into the significance of shared decision-making and the evolving role of adjunct therapies such as statins. Tune in for valuable insights and practical tips!
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Chronic Venous Disease Is Heterogeneous
- Chronic venous disease is an umbrella term that hides heterogeneous causes like post-thrombotic, non-thrombotic, superficial, and deep problems.
- Use CEEP, VCSS, and Venous clinical tools selectively because no single system captures all patients accurately.
Do A Focused History To Narrow Causes
- Take a targeted history including age at onset, prior DVT, abdominal surgery, radiation, and family history to narrow causes.
- Ask about medications and bilateral versus unilateral symptoms to identify non-venous contributors like calcium channel blockers.
Image With Provocative Ultrasound And CT/MR
- Use noninvasive ultrasound with provocative maneuvers and a tilt table to elicit reflux and assess respiratory variation.
- For suspected central obstruction, prefer CT venography for access and MR if radiation is a concern.