Current practice in treating chronic venous disease by Canadian vascular surgeons

Abstract

Objective To evaluate the practice patterns and interests of vascular surgeons in Canada in the treatment of chronic venous disorder. Methods A web-based 19-question survey was sent to 155 active members of the Canadian Society for Vascular Surgery. Questions assessed training background, interest in venous disease, practice site, venous treatments offered, and obstacles to therapy. Results A total of 64 responses (41%) were acquired. Respondents were roughly equal from academic (55%) and community (45%) sites with an even distribution of years in practice. Only 43% offered full range of therapy, which includes compression stockings, sclerotherapy, vein surgery, and endovenous ablation. The main challenges hindering venous practice include lack of time due to overwhelming arterial pathologies (67%), equipment cost/office space limitations (53%), and lack of knowledge or skills in contemporary procedures (28%). The majority of surgeons felt that their residency and fellowship did not prepare them for an active venous practice (69%). Fifty-four percent of the respondents perceived barriers in getting venous ultrasound imaging for their patients. Only 19% of the surgeons find venous disease interesting. Characteristics of these interested surgeons were analyzed and found to be very different from surgeons who did not expressed interest. An overwhelming 92% of all respondents believe that vascular surgeons should be leaders in delivering care for venous disease. Conclusion The treatment of chronic venous disorder has advanced over the last few decades but significant obstacles exist for Canadian surgeons to deliver venous therapy in accordance with current guidelines.