New Guidelines Address Chronic Venous Disease

SCAI releases recommendations for personalized treatment approaches.

The Society for Cardiovascular Angiography and Interventions (SCAI) has recently released its inaugural clinical practice guidelines focused on the treatment of chronic venous disease (CVD), offering a roadmap for clinicians and patients alike.

Key Development

These guidelines, comprised of nine formal recommendations addressing eight clinical scenarios, provide recommendations on options such as compression therapy, wound care, ablation, sclerotherapy, phlebectomy, and deep vein stenting. According to Robert Attaran, MD, MBBS, chair of the guideline writing committee, the recommendations aim to offer clinicians and patients a “roadmap for personalized, evidence-informed care.”

The guidelines help determine which patients might initially benefit from conservative treatments versus when to consider more invasive procedures.

In-Depth Analysis

The SCAI’s technical review involved an extensive search for published systematic reviews and included three de novo systematic reviews focusing on ablation therapy, sclerotherapy, and phlebectomy.

Initial screening of 3648 titles and abstracts resulted in 19 being selected to inform the technical review. Individual recommendations were classified as either “strong” or “conditional,” taking into account the certainty of the evidence and other contextual factors.

The guidelines introduce treatment algorithms for symptomatic varicose veins and for venous ulcer disease.

Limitations and Future Research

The SCAI acknowledges the uncertainty of evidence for certain treatments including perforator vein ablation, venoplasty, and stenting for iliocaval obstruction. Similarly, pooling data was challenging due to dissimilar underlying studies.

According to the National Institutes of Health, CVD affects as many as 40% of adults in the United States (NIH, 2022).

Acknowledging these limitations, the SCAI panel advocates for further research, particularly regarding specific ablation modalities for C2-C4 disease and treatment of perforator and accessory reflux.

SCAI’s Commitment

“These guidelines reflect SCAI’s commitment to bringing high-quality, evidence-based standards to areas where our members are increasingly practicing,” said SCAI president Srihari Naidu, MD. As interventional cardiologists become more involved in managing CVD, these recommendations seek to standardize and personalize patient care.

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Spotting Scarring Alopecia Early: A DermatologistS Insights – What Clinicians Need to Know

Washington, DC – Early detection is crucial in managing scarring alopecia, a challenging inflammatory condition leading to permanent hair loss. At the 2025 Society of Dermatology Physician Assistants (SDPA) Annual Summer Dermatology Conference, Maria Hordinsky, MD, R.W. Goltz Professor at the University of Minnesota Department of Dermatology, shared key insights on identifying this condition in its initial stages.

Red Flags for Clinicians:

According to Dr. Hordinsky,clinicians should be alert to patient-reported symptoms such as pain,burning,or itch localized to a specific area of the scalp.Visually,early signs include inflammation around hair follicles and general redness in the affected area,alongside noticeable hair loss [[1]]. The importance of early intervention was emphasized – catching the condition before it spreads significantly improves management options.

Differentiating Scarring Alopecia from common Conditions:

A common challenge lies in distinguishing scarring alopecia from more prevalent conditions like seborrheic dermatitis (dandruff). Dr.Hordinsky explained that patients with existing seborrheic dermatitis may experience increased inflammation in a specific scalp area when scarring alopecia develops. This localized intensification of inflammation is a key differentiator [[1]].

Understanding Scarring Alopecia:

Scarring alopecia, also known as cicatricial alopecia, destroys hair follicles, resulting in scarring and permanent hair loss [[2]]. Diagnosis typically begins with a scalp biopsy to detect inflammation and follicle damage [[3]].

resources for Patients:

for patients requiring wigs as a coping mechanism, local dermatology departments can provide facts on obtaining them, potentially through the NHS [[1]].

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