2025 SCAI慢性静脉疾病管理临床实践指南

Journal of the Society for Cardiovascular Angiography & Interventions Pub Date : 2025-08-01 DOI:10.1016/j.jscai.2025.103729

Robert R. Attaran MD, FSCAI , Matthew L. Edwards DO, FSCAI , Frank J. Arena MD, FSCAI , Matthew C. Bunte MD, MS, FSCAI , Jeffrey G. Carr MD, FSCAI , Yulanka Castro-Dominguez MD, FSCAI , Andrey Espinoza MD, FSCAI , Dmitriy N. Feldman MD, FSCAI , Scott Firestone MS , Eri Fukaya MD , Karem Harth MD , Beau M. Hawkins MD, FSCAI , Sasanka N. Jayasuriya MD, FSCAI , Pamela Kim MD , Faisal Latif MD, FSCAI , Sahil A. Parikh MD, FSCAI , Eric A. Secemsky MD, MSc, FSCAI , Emily Senerth MS, MPH , Yngve Falck-Ytter MD , Rebecca L. Morgan PhD, MPH

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引用次数: 0

摘要

背景：慢性静脉疾病（CVD）是一种常见的血管疾病，可对生活质量和日常功能产生衰弱性影响。心血管血管造影与干预学会（SCAI）寻求制定循证指南，以支持患者、临床医生和其他利益相关者在心血管疾病管理方面的治疗决策。方法scai召集了一个平衡的多学科指南小组，以尽量减少利益冲突带来的潜在偏倚。证据基金会是一家注册的501(c)(3)非营利组织，为指南的制定提供了方法上的支持。指南小组在人群、干预、比较、结果格式方面按照推荐评估、发展和评价分级（GRADE）方法制定并优先考虑临床问题。由临床和方法学专家组成的技术审查小组对已发表的证据、综合数据进行了系统审查，并对证据的确定性进行了评分。指南小组随后再次召开会议，根据技术审查结果以及GRADE从证据到决策框架中描述的其他背景因素制定建议和支持性评论。结果指南小组就9项建议达成共识，以解决8种不同临床情况下心血管疾病治疗的差异。专家组还确定了4种存在重大知识空白的解剖情景。结论：重点建议患者选择压迫治疗、隐静脉和穿支静脉消融、硬化治疗、静脉切除术和深静脉重建术。创建了两种治疗症状性静脉曲张和静脉溃疡疾病的算法，以促进这些循证建议的实施。该小组还确定了几个解剖和临床领域，未来的研究需要推进心血管疾病领域。

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2025 SCAI Clinical Practice Guidelines for the Management of Chronic Venous Disease

Background

Chronic venous disease (CVD) is a common vascular condition that can have debilitating effects on quality of life and daily function. The Society for Cardiovascular Angiography & Interventions (SCAI) sought to develop evidence-based guidelines to support patients, clinicians, and other stakeholders in their treatment decisions about management of CVD.

Methods

SCAI convened a balanced multidisciplinary guideline panel to minimize potential bias from conflicts of interest. The Evidence Foundation, a registered 501(c)(3) nonprofit organization, provided methodological support for the development of the guidelines. The guideline panel formulated and prioritized clinical questions following the Grading of Recommendations Assessment, Development and Evaluation (GRADE) approach in population, intervention, comparison, outcome format. A technical review team of clinical and methodological experts conducted systematic reviews of the published evidence, synthesized data, and graded the certainty of the evidence across outcomes. The guideline panel then reconvened to develop recommendations and supporting remarks informed by the results of the technical review, as well as additional contextual factors described in the GRADE evidence-to-decision framework.

Results

The guideline panel reached consensus on 9 recommendations to address variations in treatment of CVD across 8 different clinical scenarios. The panel also identified 4 anatomical scenarios with significant knowledge gaps.

Conclusions

Key recommendations address patient selection for compression therapy, ablation of saphenous and perforator veins, sclerotherapy, phlebectomy, and deep vein revascularization. Two algorithms for the management of symptomatic varicose veins and venous ulcer disease were created to facilitate implementation of these evidence-based recommendations. The panel also identified several anatomical and clinical areas where future research is needed to advance the CVD field.

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来源期刊

Journal of the Society for Cardiovascular Angiography & Interventions Cardiology and Cardiovascular Medicine

CiteScore

1.40

自引率

0.00%

发文量

审稿时长

48 days