VASCULAR | Chronic venous disease: what's the big deal?
Tracks
216
| Sunday, June 15, 2025 |
| 9:00 AM - 10:30 AM |
| 216 | Lecture Rm |
Overview
Chair | Mr Sean Coveney
Speaker
Mr Christopher Sykes
Sykes Legal
Planning for treatment ultrasound requirements
9:20 AM - 9:40 AMAbstract
Planning for varicose vein treatment is a mystery to many sonographers, particularly if they have not had the advantage of working in a vascular surgery environment. This means that for a majority of sonographers, they may have a good theoretical understanding of how to do a varicose vein examination, but they may not understand why they are doing the scan. This presentation will step through what a sonographer should be considering if they are asked to perform a scan for surgical planning for varicose veins.
However, what attendees will really come to understand is that considerations relevant for surgical planning should, in fact, be front of mind when performing all vascular examinations. In that way, the presentation will help attendees understand why they are doing a scan and what they should be looking for. The presentation will be relevant to any sonographer performing vascular examinations. For beginners, the presentation will demystify varicose vein examinations. Those with some experience will gain new insights. Experts will be invited to reflect on their own practice (and they might pick some useful tips).
However, what attendees will really come to understand is that considerations relevant for surgical planning should, in fact, be front of mind when performing all vascular examinations. In that way, the presentation will help attendees understand why they are doing a scan and what they should be looking for. The presentation will be relevant to any sonographer performing vascular examinations. For beginners, the presentation will demystify varicose vein examinations. Those with some experience will gain new insights. Experts will be invited to reflect on their own practice (and they might pick some useful tips).
Biography
Mr Christopher Sykes |
Sykes Legal
Christopher has extensive public and private clinical experience in medical ultrasound. He has lectured in post graduate ultrasound physics and instrumentation and was a physics and clinical examiner for ASUM in addition to being a member of the ASUM Board of Examiners. He is the previous Chair of the Australian Sonographer Accreditation Registry.
Christopher completed his Juris Doctorate in 2008 and has worked extensively in health law, providing advice to public and private health services and governments across Australia. He is currently Corporate Counsel at Latrobe Regional Health and provides advice to all aspects of the business. He also consults privately in health law matters and delivers medicolegal training. He is a director at Echuca Regional Health. In addition to his legal work, Christopher runs a vascular ultrasound consultancy.
Dr Peter Milne
Laser Vein Co
Perforators - current management
9:40 AM - 10:00 AMAbstract
Venous disease has been recognised as a source of lower limb difficulties, mainly ulceration and scarring, for centuries. Egyptian, Greek and Roman practitioners all developed various methods of controlling venous disease of which ulceration was their major difficulty. The Romans developed hooks and previous physicians have noted the value of elevation.
After the Second World War classic saphenous trunk extraction by the Trendelenburg method was utilised but this appeared to be inadequate to provide complete relief of venous disease in many cases.
An increasing interest in perforator disease culminated in the book by Harold Dodd and Frank Cockett. This was an attempt to anatomically describe consistent points of perforators in the lower limb venous anatomy.
Until the advent of ultrasound, detection of perforators was on a clinical basis by means of palpation and to see if control of venous distention could be achieved by fingertip pressure over the perforator. The advent of bi-directional colour Dopper in the 90's immediately resulted in a huge advance in the detection of perforator disease and classification simply became more confusing because of variable anatomy. During this period my observation was that perforator disease was the usual source of difficulty associated with venous ulceration, liposclerosis and haemorsiderin deposition, this phenomenon giving rise to the "champagne-bottle" leg.
In this decade therefore, control of perforators with laser has become the gold standard because of the high success rate and the lack of superficial complications of skin necrosis.
After the Second World War classic saphenous trunk extraction by the Trendelenburg method was utilised but this appeared to be inadequate to provide complete relief of venous disease in many cases.
An increasing interest in perforator disease culminated in the book by Harold Dodd and Frank Cockett. This was an attempt to anatomically describe consistent points of perforators in the lower limb venous anatomy.
Until the advent of ultrasound, detection of perforators was on a clinical basis by means of palpation and to see if control of venous distention could be achieved by fingertip pressure over the perforator. The advent of bi-directional colour Dopper in the 90's immediately resulted in a huge advance in the detection of perforator disease and classification simply became more confusing because of variable anatomy. During this period my observation was that perforator disease was the usual source of difficulty associated with venous ulceration, liposclerosis and haemorsiderin deposition, this phenomenon giving rise to the "champagne-bottle" leg.
In this decade therefore, control of perforators with laser has become the gold standard because of the high success rate and the lack of superficial complications of skin necrosis.
Biography
Dr Peter Milne |
Laser Vein Co
Peter Y. Milne originally trained in General Surgery but has specialised in Vascular Surgery since 1980. He was trained in Cardiovascular Surgery at the Methodist Hospital, Houston, Texas and in Vascular Surgery at Royal Melbourne and Epsom District Hospital, London UK.
He established the Melbourne Vascular Surgery Unit in 1985. Mr Milne’s expertise and special interests include varicose vein treatment by surgery, laser and sclerotherapy including embolisation for pelvic congestion. Mr Milne sat on the Medicare Committee for 3 years to acquire Item Numbers for Laser treatment for Varicose veins. Mr Milne’s arterial interests are aneurysm repair (by open surgery and endovascular means) as well as carotid surgery and/or stenting for stroke prevention. He also performs limb bypass surgery as well as minimally invasive techniques of angioplasty and stenting.
Major advances in venous technologies required the assistance of skilled and perspicacious sonographers to advance coil embolisation and laser ablation to assist Mr Milne to remain at the forefront of venous disease management.
Ms Amy Clough
Sonic Resolutions
Post-operative ultrasound following endovenous ablation
10:00 AM - 10:20 AMAbstract
Ultrasound is the gold standard diagnostic imaging modality for pre and post-operative endovenous ablation treatments.
This lecture will provide insights into:
Endovenous ablation of saphenous trunks and perforators.
Post-operative thermal and non-thermal endovenous ablation ultrasound appearances, including E-HIT and E-GIT.
Risk factors for post-operative complications.
Clinical and ultrasound appearances of post-operative complications.
Lack of consensus on validity and guidelines for post-operative follow up ultrasound.
The roles of short term and long term post-operative follow up ultrasound.
This lecture will provide insights into:
Endovenous ablation of saphenous trunks and perforators.
Post-operative thermal and non-thermal endovenous ablation ultrasound appearances, including E-HIT and E-GIT.
Risk factors for post-operative complications.
Clinical and ultrasound appearances of post-operative complications.
Lack of consensus on validity and guidelines for post-operative follow up ultrasound.
The roles of short term and long term post-operative follow up ultrasound.
Biography
Ms Amy Clough |
Sonic Resolutions
Amy is a vascular sonographer based in Melbourne. She has been at the forefront of innovative endovenous procedural techniques in Australia. Amy was the head sonographer in the teams that introduced RFA, EVLA, Clarivein and Venaseal to Australia. Amy is a keen technical writer and has co-authored two vascular ultrasound textbooks.
