1. Chronic Venous Insufficiency S. Lakhanpal MD, FACS President & CEO Center for Vein Restoration

2. Chronic Venous Insufficiency Summary Is the most common vascular disease: >25 million in the U.S. Most common cause of leg edema in adults Sequelae: varicose veins, leg edema, skin discoloration, thickening, ulceration Aching, fatigue, cramping, heaviness, pain Once diagnosed appropriately, very easy to treat

3. Incidence of Venous Insufficiency Amongst the adult population: Presence of Venous Insufficiency in Adults Females: 25% Males: 15% Once Over Age 50 Females: 50% Males: 30% Patients with Severe Venous Insufficiency Patients with healed ulcers : 1-2% Active venous ulcers : 0.3% Fowkes FG, Evans CJ, Lee AJ, Angiology. 2001 Aug;52 Suppl 1:S5-15 Carpentier PH, Maricq HR, Biro C, Ponçot-Makinen CO, Franco A, J Vasc Surg. 2004 Oct;40(4):650-9

4. If You See About 50 Patients A Day Presence of symptomatic venous insufficiency Females: 12.5 Males: 7.5 Patients with severe venous insufficiency Patients with healed ulcers: 1 daily Active venous ulcers: one in three days

5. Venous Disease – Impact Related To The Disease Almost 2 million working days are lost/year due to venous ulcers. Annual health care cost approx. $3 billion in the U.S. Associated with a reduced quality of life, particularly in relation to pain, physical function, and mobility. Associated with depression and social isolation. The impairment associated with advanced stages has been likened to the impairment associated with heart failure. Bergan et al. N Engl J Med 2006;355:488-98

6. BREAKING NEWS July 2013– National Institutes for Health and Care Excellence Varicose veins in the legs- The diagnosis and management of varicose veins Do not offer compression hosiery to treat varicose veins unless interventional treatment is unsuitable. Refer to a vein specialist any person with a symptomatic varicose vein, bleeding varicose vein or superficial vein thrombosis. It costs more health care dollars, not to treat varicose vein disease at any stage. NICE clinical guideline 168, 2013 http://www.nice.org.uk/guidance/cg168

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