Endovascular Oriented Classification and Treatment of Celiac Trunk Aneurysms: 10 Years Experience.

OBJECTIVE: To propose an endovascular-oriented classification of celiac trunk aneurysms (CTa) and discuss single center results of this rare pathology. METHODS: Data of all patients admitted to our institution for CTa from 2011 to 2021 were prospectively collected. Of them, those who underwent endovascular treatment were retrospectively analyzed. All preoperative CT scans were reviewed and CTa were classified in 4 different configurations based on progressive distal landing zone. We excluded from the classification all cases with median arcuate ligament syndrome (MALS), patients with coexistent aortic dilation or no endovascular proximal neck. Preoperative demographics, intraoperative data and post-operative complications were recorded. All-cause late mortality and complications were identified through a review of office charts and telephone assessment. RESULTS: During the study period 19 patients were referred to our Institution for CTa. Ten patients underwent endovascular treatment (ET). In 6 cases a watchful waiting strategy was adopted, 2 (10.5 %) patients refused ET and one patient without suitable proximal landing zone (< 10 mm) was not proposed to open surgical repair for surgical contraindication but is followed by strict instrumental and clinical evaluation. Six (60%) patients presented type 2 CTa; all of them underwent ET requiring positioning of covered stent-graft and SA embolization. Three (30%) patients presented type 3 CTa; all of them underwent ET with covered stent-graft deployment over the GDA with preliminary embolization. One (10%) patient presented type 4 CTa that was treated by means of covered stent-graft deployment along the right hepatic artery with left hepatic artery embolization. Overall, no major complications and perioperative mortality was observed. CONCLUSION: Celiac trunk aneurysms are rare, and no classifications have still been presented. Stent-graft exclusion provides excellent short-term outcome with no significant morbidity and mortality rate when technically feasible.

Artificial Intelligence Methods for Rapid Vascular Access Aneurysm Classification in Remote or In-Person Settings.

BACKGROUND: Innovations in artificial intelligence (AI) have proven to be effective contributors to high-quality health care. We examined the beneficial role AI can play in noninvasively grading vascular access aneurysms to reduce high-morbidity events, such as rupture, in ESRD patients on hemodialysis. METHODS: Our AI instrument noninvasively examines and grades aneurysms in both arteriovenous fistulas and arteriovenous grafts. Aneurysm stages were adjudicated by 3 vascular specialists, based on a grading system that focuses on actions that need to be taken. Our automatic classification of aneurysms builds on 2 components: (a) the use of smartphone technology to capture aneurysm appearance and (b) the analysis of these images using a cloud-based convolutional neural network (CNN). RESULTS: There was a high degree of correlation between our noninvasive AI instrument and the results of the adjudication by the vascular experts. Our results indicate that CNN can automatically classify aneurysms. We achieved a >90% classification accuracy in the validation images. CONCLUSION: This is the first quality improvement project to show that an AI instrument can reliably grade vascular access aneurysms in a noninvasive way, allowing rapid assessments to be made on patients who would otherwise be at risk for highly morbid events. Moreover, these AI-assisted assessments can be made without having to schedule separate appointments and potentially even via telehealth.

Brief review: Pulmonary artery aneurysms and pseudoaneurysms.

The purpose of this review article is to provide a brief overview of pulmonary artery aneurysms and pseudoaneurysms, to discuss the classifications of these conditions, review the role of imaging and discuss management in affected patients.

High-Grade Aneurysmal Subarachnoid Hemorrhage: Predictors of Functional Outcome.

BACKGROUND: Because the prognosis of high-grade aneurysmal subarachnoid hemorrhage (aSAH), classified as World Federation of Neurosurgical Societies (WFNS) grade IV-V, is generally poor, the functional outcomes of survivors have not been thoroughly explored. The aim of this retrospective cohort study is to determine predictors of functional independence in patients who survive a high-grade aSAH. METHODS: We retrospectively evaluated consecutive patients with aSAH admitted to a single institution from January 2000 to April 2015. Adult (age ≥18 years) patients with WFNS grade IV-V aSAH were included for analysis. Patients without sufficient baseline data, those who died before discharge, and those without follow-up data were excluded. Univariable and multivariable logistic regression analyses were used to identify factors associated with functional independence, defined as a modified Rankin Scale score of 0-2, at last follow-up. RESULTS: Of the 260 patients with a WFNS grade IV-V aSAH during the study period, 139 met the inclusion criteria. After a mean follow-up of 6.3 months, functional independence was achieved in 73% of high-grade aSAH survivors (101/139 patients) and in 39% of all high-grade aSAH cases (101/260 patients). Only a lack of cerebrospinal fluid shunt placement was found to be an independent predictor of functional independence in the multivariable analysis (odds ratio 0.28 [0.109-0.722]; P = 0.008). CONCLUSIONS: Because functional independence can be achieved in the majority of high-grade aSAH survivors, aggressive initial management of high-grade aSAH is warranted. Strategies that reduce the need for permanent cerebrospinal fluid diversion may improve functional outcomes in survivors of high-grade aSAH.

Strategies for endovascular treatment of complicated splenic artery aneurysms.

OBJECTIVE: Endovascular treatment (ET) is being increasingly used for splenic artery aneurysms (SAAs), but systematic treatment strategies have not been defined. We set out to investigate the optimal strategies for ET of complicated SAAs (CSAAs). METHODS: CSAAs were classified into three types: type I, rupture or impending rupture; type II, at the origin of the splenic artery; and type III, having an aberrant splenic artery from the splenomesenteric trunk (type IIIA) or celiacomesenteric trunk (type IIIB). SAAs treated at our center during the last decade were reviewed, and CSAAs were selected for analysis. Patients' demographics, clinical manifestations, aneurysm characteristics, ET strategies, and outcomes were analyzed. RESULTS: A total of 154 SAAs were identified, with 24 (15.6%) being CSAAs. Open surgery was employed in two patients, whereas 22 patients underwent ET. There were 3 patients with type I (type IIIA co-occurred in one of them), 5 with type II, and 15 with type III CSAAs. Treatment strategies included the following: immediate and thorough exclusion with embolization of the collaterals for type I; and dense embolization of the sac and outflow artery, with or without embolization of the inflow artery, or covered stent placement in the splenomesenteric trunk or celiacomesenteric, for types II and III. Technical success was achieved in 21 patients (95.5%). Mean follow-up was 33.7 ± 31.2 months (range, 1.5-117.0 months). The aneurysms remained completely thrombosed and unenlarged in 21 patients (95.5%). Reintervention was needed in one patient (4.5%) for persistent sac enlargement. The covered stent was asymptomatically occluded in one patient (11.1%). No hepatic or intestinal ischemia or death developed perioperatively or during the follow-up period. CONCLUSIONS: With reasonable strategies toward the urgency and thoroughness needed for aneurysm exclusion as well as the anatomic challenges, ET appeared to be feasible, safe, and effective in the management of CSAAs.

Endovascular Treatment of Spontaneous Intracranial Fusiform and Dissecting Aneurysms: Outcomes Related to Imaging Classification of 309 Cases.

OBJECTIVE: To propose a modified classification system for spontaneous intracranial dissecting aneurysms (IDAs) that can guide treatment decisions. METHODS: Between January 2010 and December 2015, 3183 consecutive patients were referred to our department for endovascular treatment of a cerebral aneurysm. Among this group, 309 patients harboring a total of 323 spontaneous IDAs were identified. Based on a modified imaging classification system, spontaneous IDAs were classified into 4 subtypes: classic dissecting aneurysm, segmental ectasia, dolichoectatic dissecting aneurysm, and large mural bleeding ectasia. A logistic regression analysis was conducted to identify predictors of clinical outcomes. RESULTS: Of the 323 IDAs, 216 (66.87%) were treated with stent-assisted coiling, 47 (14.55%) with internal trapping, and 60 (18.58%) with sole stenting. Of the 309 patients, 8 (2.59%) suffered intraoperative complications, 40 (12.94%) experienced postoperative complications, 9 died (2.79%), and 1 (0.32%) had severe disability. The mean duration of clinical follow-up of the 309 patients was 10.40 months (range, 3-72 months). Imaging follow-up was available for 262 patients (274 IDAs), with a mean duration of 7.10 months (range, 3-60 months), and 24 aneurysm recurrences (9.16%) were noted. Aneurysm type was the sole independent predictor of different outcomes on logistic regression analysis (P = 0.004). CONCLUSIONS: There was a strong relationship between the subtypes of spontaneous IDAs and clinical course. Our classification system is confirmed to be helpful in assessing patients' prognosis and guiding their treatment.

Treatment Strategy for Persistent Sciatic Artery and Novel Classification Reflecting Anatomic Status.

BACKGROUND: Persistent sciatic artery (PSA) is a relatively rare congenital variant of the lower limb vasculature and can have highly variable clinical presentations. The purpose of this study was to analyze the relationship between PSA anatomy and clinical presentation, and to suggest an optimal management strategy. METHODS: Between 2001 and 2014, 24 PSAs in 19 patients were diagnosed by computed tomography and referred to the vascular surgery department. Patient demographics, types of PSA and femoral artery, aneurysmal changes, symptoms, and treatment methods were assessed. Additionally, all English literature from 1964 to 2014 was reviewed and compared using the PubMed database (224 PSAs in 171 patients). RESULTS: PSA was diagnosed in 10 men (52.6%) and nine women (47.4%). PSAs were bilateral in five patients (26.3%) and symptomatic in 12 patients, while in seven patients PSA was found incidentally. According to the Pillet-Gauffre classification, Type 2a was the most common variant (n = 15/24, 62.5%), with unclassifiable types in two limbs. Compared with cases in the literature, the PSA occlusion rate in this study was higher (n = 10/24, 41.7% vs. n = 54/224, 27.5%), but aneurysm incidence was higher in the literature cases (n = 5/24, 20.8% vs. n = 112/224; 50.7%). In this study, 16 limbs (66.6%) were treated conservatively, and six limbs were treated by open surgery, including four bypasses, one amputation, and one thrombo-embolectomy. Endovascular coil embolization was performed in one limb, and a hybrid procedure with stent graft was performed in one limb with PSA aneurysm. Based on the present series and the literature review, a new classification system and treatment option is proposed according to the anatomic status and the presence of aneurysm. According to the new classification, class III was the most common in both the present study (18/24; 75%) and the literature review, and the presence of aneurysm was the most important determinant of surgical treatment. CONCLUSIONS: The new classification system is simple and provides guidance for management. Limb anatomy of the femoral artery system and the presence of PSA aneurysm should be considered when selecting the optimal treatment. The risk of embolism from the presence of aneurysm is an important factor for treatment, and bypass surgery is mostly required in classes III and IV.

Aneurisma verdadeiro pós-traumático de artéria temporal / True posttraumatic aneurysm of the temporal artery

Os aneurismas de artéria temporal pós-traumático são eventos raros. Geralmente, são pseudoaneurismas. Como a causa mais frequente são ferimentos contusos, deve-se investigar todo paciente que possuir nodulação pulsátil na região da artéria temporal. O paciente apresentava protuberância pulsátil em região frontal direita há quatro meses, após queda de objeto pontiagudo, e o eco-Doppler evidenciou dilatação aneurismática. Assim, foi indicada sua excisão, que foi realizada com sucesso. O exame anatomopatológico demonstrou aneurisma verdadeiro traumático de artéria temporal superficial. Ocorrem devido ao fato de a artéria temporal superficial se localizar diretamente sobre o periósteo, o que a torna muito superficializada. Os aneurismas verdadeiros pós-traumáticos de artéria temporal são extremamente raros e podem ser confundidos com diversas outras afecções, como lipomas e cistos sebáceos.

Posttraumatic aneurysms of the temporal artery are rare events and are generally pseudoaneurysms. Since the most frequent cause is blunt injury, all patients with a pulsating nodule in the region of the temporal artery should be investigated. This patient presented with a pulsating protuberance in the right frontal area with onset 4 months previously after being hit by a falling sharp object. Doppler ultrasonography showed evidence of aneurysmal dilatation, which was excised successfully. Pathology results demonstrated a true traumatic aneurysm of the superficial temporal artery. They occur because the superficial temporal artery is located directly over the periosteum, meaning it is very superficial. True posttraumatic aneurysms of the temporal artery are extremely rare and may be confused with many other conditions, such as lipomas and sebaceous cysts.

True aneurysm in autologous hemodialysis fistulae: definitions, classification and indications for treatment.

INTRODUCTION: Definition, etiology, classification and indication for treatment of the arteriovenous access (AVA) aneurysm are poorly described in medical literature. The objectives of the paper are to complete this information gap according to the extensive review of the literature. METHODS: A literature search was performed of the articles published between April 1, 1967, and March 1, 2014. The databases searched included Medline and the Cochrane Database of Systematic Reviews. The eligibility criteria in this review studies the need to assess the association of aneurysms and pseudoaneurysms with autologous AVA. Aneurysms and pseudoaneurysms involving prosthetic AVA were not included in this literature review. From a total of 327 papers, 54 non-English papers, 40 case reports and 167 papers which did not meet the eligibility criteria were removed. The remaining 66 papers were reviewed. RESULTS: Based on the literature the indication for the treatment of an AVA aneurysm is its clinical presentation related to the patient's discomfort, bleeding prevention and inadequate access flow. A new classification system of AVA aneurysm, which divides it into the four types, was also suggested. CONCLUSIONS: AVA aneurysm is characterized by an enlargement of all three vessel layers with a diameter of more than 18 mm and can be presented in four types according to the presence of stenosis and/or thrombosis. The management of an AVA aneurysm depends on several factors including skin condition, clinical symptoms, ease of cannulation and access flow. The diameter of the AVA aneurysm as a solo parameter is not an indication for the treatment.

Management of inferior vena cava aneurysm.

AIM: Inferior vena cava (IVC) aneurysm is an infrequent but potentially lethal abnormality. We have seen one such case in our group practice. We have added this case to a review of 53 previously reported cases in order to develop a management algorithm for this entity. METHODS: We conducted a MedLine search of all English-language articles from the first reported case in 1950 through August 2013. Patient demographics, clinical data, management and outcomes were extracted. IVC aneurysms were categorized in 4 types as per Gradman and Steinberg classification. RESULTS: The mean patient age was 27.1 years (range 5-89) and 57.4% were male. A total of 11 (20.3%) had associated vascular anomalies and iliocaval thrombosis was found in 10 (18.5%). There were 23 type I aneurysms, 8 type IIs, 21 type IIIs and 2 type IVs. All but 1 type I was successfully managed conservatively without complications. For type IIs, only 3 patients were managed conservatively with 1 death related to stroke from paradoxical embolus. For type IIIs, resection was the most common management option (14 patients). One patient was treated endovascularly with aneurysm embolization. A total of 6 asymptomatic patients were treated conservatively with 1 death due to thromboembolism. For type IVs, all cases underwent expectant management with 1 death due to aneurysm rupture. CONCLUSION: IVC aneurysms are rare with only 54 cases reported in the literature. Associated vascular anomalies and iliocaval thrombosis should be expected in approximately 20% of cases. Type I aneurysms can be managed expectantly with close surveillance unless symptomatic. For type II-IV, surgical consideration should be given based on high rates of thromboembolic complications and non-negligible risk of rupture.

A novel classification system for autogenous arteriovenous fistula aneurysms in renal access patients.

INTRODUCTION: Arteriovenous fistulae (AVFs) constructed for hemodialysis access are prone to aneurysmal degeneration. This can lead to life-threatening sequelae such as aneurysmal rupture. The literature includes various guidelines on the management of certain aspects of access-related aneurysm formation; however, no classification system exists to guide reporting or prognostication. We aimed to create a universally acceptable classification for these aneurysms and establish guidance about their management. METHODS: We clinically examined, duplex scanned, and photographed all of the autologous arteriovenous fistulae in our local renal failure population in January 2010 in order to categorize morphology. We then followed up the cohort for 2 years prospectively to assess outcomes, primarily of rupture or surgical intervention for bleeding. RESULTS: A total of 344 patients were included (292 currently needling their fistula and 52 with low creatinine clearance awaiting dialysis). In all, 43.5% of dialyzed patients had aneurysmal fistulae. We propose a classification system as follows: type 1a: dilated along the length of the vein; type 1b: postanastomotic aneurysm; type 2a: classic "camel hump"; type 2b: combination of type 2a and 1b; type 3: complex; and type 4: pseudoaneurysm. Six fistulae needed emergency surgery for bleeding in the 2-year follow-up period and 5 of these were type 2 aneurysms. The remaining one was in the nonaneurysmal group, although it had become aneurysmal by the time it bled. CONCLUSION: Type 1 aneurysms are much commoner in patients who have not yet needled their fistula and have a relatively innocuous course although type 1a aneurysms should be monitored for high flow and physiological consequences thereof. Type 2 aneurysms are associated with needling of AVFs. They are at significant risk of rupture and need to be monitored carefully or treated prophylactically.

Classification of human retinal microaneurysms using adaptive optics scanning light ophthalmoscope fluorescein angiography.

PURPOSE: Microaneurysms (MAs) are considered a hallmark of retinal vascular disease, yet what little is known about them is mostly based upon histology, not clinical observation. Here, we use the recently developed adaptive optics scanning light ophthalmoscope (AOSLO) fluorescein angiography (FA) to image human MAs in vivo and to expand on previously described MA morphologic classification schemes. METHODS: Patients with vascular retinopathies (diabetic, hypertensive, and branch and central retinal vein occlusion) were imaged with reflectance AOSLO and AOSLO FA. Ninety-three MAs, from 14 eyes, were imaged and classified according to appearance into six morphologic groups: focal bulge, saccular, fusiform, mixed, pedunculated, and irregular. The MA perimeter, area, and feret maximum and minimum were correlated to morphology and retinal pathology. Select MAs were imaged longitudinally in two eyes. RESULTS: Adaptive optics scanning light ophthalmoscope fluorescein angiography imaging revealed microscopic features of MAs not appreciated on conventional images. Saccular MAs were most prevalent (47%). No association was found between the type of retinal pathology and MA morphology (P = 0.44). Pedunculated and irregular MAs were among the largest MAs with average areas of 4188 and 4116 µm(2), respectively. Focal hypofluorescent regions were noted in 30% of MAs and were more likely to be associated with larger MAs (3086 vs. 1448 µm(2), P = 0.0001). CONCLUSIONS: Retinal MAs can be classified in vivo into six different morphologic types, according to the geometry of their two-dimensional (2D) en face view. Adaptive optics scanning light ophthalmoscope fluorescein angiography imaging of MAs offers the possibility of studying microvascular change on a histologic scale, which may help our understanding of disease progression and treatment response.

Spinal aneurysms: clinicoradiological features and management paradigms.

OBJECT: Spinal aneurysms (SAs) are rare lesions. The clinicoradiological features and the exact degree of their association with comorbid conditions such as arteriovenous malformations (AVMs) and coarctation of the aorta have not been definitively described. The ideal management paradigm has not been established. The authors reviewed literature to determine the clinical patterns of presentation, management, and outcome of spinal aneurysms. METHODS: A systematic review of literature was performed using 23 separate strings. A total of 10,190 papers were screened to identify 87 papers that met the inclusion criteria. A total of 123 SAs could be included for analysis. RESULTS: The mean age of patients at presentation was 38 years; 10% of patients were aged less than 10 years and nearly 50% were greater than 38 years. Spinal aneurysms can be divided into 2 groups: those associated with AVMs (SA-AVMs, or Type 1 SAs) and those with isolated aneurysms (iSAs, or Type 2 SAs). Patients with Type 2 SAs were older and more likely to present with bleeding than those with Type 1 SAs. The acute syndromes can be divided into 3 groups of patients: those with spinal syndrome, those with cranial/craniospinal syndrome, and those with nonspecific presentation. Overall, 32.6% presented with angiography-negative cranial subarachnoid hemorrhage (SAH). Presentation with evidence of cord dysfunction (myelopathy/weakness/sensory loss/bladder involvement) correlated with poor outcome, as did presentation with hemorrhage and association with other comorbid conditions. Surgery and endovascular therapy both led to comparable rates of complete aneurysm obliteration for Type 2 SAs, whereas for the AVM-associated Type 1 SAs, surgery led to better rates of lesion obliteration. The authors propose a classification scheme for spinal aneurysms based on whether the lesion is solitary or is associated with a coexistent spinal AVM; this would also imply that the ideal therapy for the aneurysm would differ based on this association. CONCLUSIONS: The clinical and radiological patterns that influence outcome are distinct for Type 1 and Type 2 SAs. The ideal treatment for Type 1 SAs appears to be excision, whereas surgery and endovascular therapy were equally effective for Type 2 SAs.

An observational study into the management of arteriomegaly: a call for a revised classification system.

INTRODUCTION: Arteriomegaly is the diffuse ectasia of arteries with or without aneurysmal disease. Patients with arteriomegaly have a higher incidence of morbidity including limb loss compared to patients with other arteriopathies. The aim of this observational study was to review the management of these patients in our institution. METHODS: Radiologists and surgeons prospectively reviewed aortofemoral angiography. Patients with arteriomegaly were identified. Data relating to demographics, mode of presentation, risk factors, type of arteriomegaly, management and progression of disease were analysed. RESULTS: Arteriomegaly was identified in 1.3% of patients (n = 69) undergoing lower limb angiography in the study period. Of these, the majority (n = 67) were men. The mean age was 74 years (range: 60-89 years) and 76% were smokers. Co-morbidities included coronary artery disease (55%), diabetes mellitus (20%), hypertension (45%) and cerebrovascular events (6%). Forty-nine patients presented with critical limb ischaemia and eighteen patients were seen electively in the outpatients department with symptoms of intermittent claudication. Data were incomplete for two male patients and were therefore not included. At presentation, 22 patients were classified as Hollier type I, 5 were type II and 9 were type III. Thirty-one patients had arteriomegalic vessels but no aneurysmal disease. After a median follow-up duration of 76 months (range: 6-146 months), 34 patients progressed to type I, 2 to type II and 18 to type III. Thirteen remained without aneurysmal disease. Twenty-nine patients required angioplasty and twenty-eight required bypass surgery during this time. In total, 102 procedures were required for complicated disease. The limb salvage rate was 92%. Although 8 patients in our series died, the remaining 59 are under regular follow up. CONCLUSIONS: This study illustrates the progressive nature of arteriomegaly. Results of the management of these patients in our institution are similar to those in the literature. We suggest an additional fourth category to Hollier's classification that describes arteriomegalic disease without aneurysmal degeneration as this, too, deserves special management. Regular follow-up visits and early intervention for patients with arteriomegaly is advocated to reduce the high incidence of morbidity.

Imaging of non-atherosclerotic aneurysmal disease.

Atherosclerotic aneurysms account for about 95% of all aneurysms. This overview concentrates on the 5% leftover, which however represents a heterogenic group of aneurysms with a wide range of different pathogenesis. Thus, therapy is not exclusively restricted to the exclusion of the aneurysm. In non-atherosclerotic aneurysmal disease various additional therapeutic strategies are included such as chemotherapy, anti-inflammatory therapy and embolisation procedures. Diagnosis, therapeutic decision making and even therapy itself to a growing extent depends on adequate (pretherapeutic) imaging and therefore radiologic expertise. This review describes the most common forms of non-atherosclerotic aneurysms and focuses on their pathogenesis, potential diagnostic approaches and therapy options.

A Study of Extracranial Aneurysms at UNTH in Enugu; Nigeria

Previous studies on aneurysms in Nigeria have either been case reports or studies of peripheral aneurysms. No study has comprehensively evaluated all aspects of this disease as an entity among Nigerians. The need therefore arises to re-evaluate this lesion so as to make deductions on incidence; sex ratio; aetiology and management. This is a retrospective descriptive study of arterial aneurysms at the University of Nigeria Teaching Hospital (UNTH); Enugu. Those treated between January 1993 and December 2002 were included for the study. Datawere obtained frommedical records for all patients admittedwith aneurysms over the study period. Atotal of 26 patientswere admitted during the period; but 24 case noteswere analysed. The age rangewas 10-75 yearswithmale: female ratio of 1.4:1. Traumatic pseudo aneurysms accounted for 16 cases (67.0)while true aneurysms comprised the remaining.Of all the aneurysms; femoral artery with most of the pseudo aneurysms had 8 out of 24 (33.0).This is followed by the infra-renal abdominal aorta (5/24; 21.0) and other sites (11/24; 46.0). Diagnoses were made clinically in most cases and by abdominal ultrasonography in abdominal aortic aneurysms. Twenty-one patients had surgical interventionwith 9.5operativemortality. The incidence of aneurysm is low in our locality (2.6/year) based on the rate of diagnosis.Abdominal aorta harbours most of the true aneurysms with diameter ranging from 8.0-15.0cm without rupture. Untreated; all will eventually rupture with catastrophic consequences. Treatment involved excision with graft interposition. This is not only expensive but the graft is often not readily available. As a solution; grafts should be stocked with drug revolving fund

Updated terminology of chronic venous disorders: the VEIN-TERM transatlantic interdisciplinary consensus document.

Non-uniform terminology in the world's venous literature has continued to pose a significant hindrance to the dissemination of knowledge regarding the management of chronic venous disorders. This VEIN-TERM consensus document was developed by a transatlantic interdisciplinary faculty of experts under the auspices of the American Venous Forum (AVF), the European Venous Forum (EVF), the International Union of Phlebology (IUP), the American College of Phlebology (ACP), and the International Union of Angiology (IUA). It provides recommendations for fundamental venous terminology, focusing on terms that were identified as creating interpretive problems, with the intent of promoting the use of a common scientific language in the investigation and management of chronic venous disorders. The VEIN-TERM consensus document is intended to augment previous transatlantic/international interdisciplinary efforts in standardizing venous nomenclature which are referenced in this article.