Vein Specialist

Table of contents

EDITOR-IN-CHIEF
Steve Elias, MD 

EXECUTIVE EDITOR
John Forbes, MBA 

MANAGING EDITOR
Allison DeGroff 

COVER ARTIST
Christine Rataj

PUBLICATION DESIGNER
Anthony Eaves

The Known Unknown

“I don’t want clothes to overtake my life. I just want to wear them and let them serve me. ”This quote by the designer Nili Lotan gives the inanimate objects of clothing human attributes. The verbs “overtake” and “serve” imply a conscious effort by articles of clothing to do something. I never thought of clothes this way. Most of us buy clothes, put them in our closets, and take them out when we need them. We tell our clothes what they need to do that day or that night. But we are not fashion designers as Nili Lotan is. We don’t live with clothes; we just wear them. She says, “I started my business for women with what you need and then I’ve added what you want.” She has been described as dressing like a female Bob Dylan by the singer Alison Moshart of the rock group The Kills. Is it coincidental that Dylan wrote in the song Stuck Inside of Mobile with The Memphis Blues Again, “Your debutante knows what you need, but I know what you want.? And she riffs on it. Coincidence? As Ian Fleming wrote in his 1959 novel Goldfinger, “Once is happenstance, twice is coincidence and the third time is enemy action.” Things don’t just happen and it is probably not coincidental.

And it is not coincidental, but rather purposeful, that in this issue of Vein Specialist we need you and we need others. This issue is about our annual meeting and about our members and the need for new members. Read the articles that tell you what’s happening at our annual meeting. What’s new, what’s usual, and what is unusual. Members of our program committee give you some summary and highlights as to what will be happening. This will be a slightly different meeting from our usual as we are incorporating new ideas, more interactive discussion, and educating our physicians-in-training as well as APPs. Our program chairs, Misaki Kiguchi and Julianne Stoughton, have done an excellent job being as innovative and as diverse as possible. Our cover features a well-known figure, Uncle Sam. He implores us and says we need you as members. An organization is only as good as its members and we are always looking for new ones to bring novel ideas that can contribute to and influence the direction of our society.

And now you know our contributors and our influencers in this issue. Nili Lotan, our known unknown designer, has a few influencers also. “Secretly I’ve always tried to style myself on Jane Birkin and Anita Pallenberg.” I am not going to go into who these people were if you don’t know, but Google them and you will better understand our known unknown designer. She can style herself any way she wants because she has money. And you need money to buy really expensive shoes. Particularly the John Lobb Lopez 75 loafer. $2575 for a handmade, one of 500, loafer. John Lobb is a shoe-making company from Northampton, England, which is the center of the shoe-making universe–a universe that dates back to the 1400s when Northampton became the shoe-making place in England and the world. John Lobb developed a technique to create a handmade shoe from one continuous piece of leather. As the AVF has continued as one organization for many years, made-up of our engaged members and our annual meeting and more. Come to the meeting, meet your fellow members. We want you. And we want you to dress as you want. Tell your clothes what they need to do for you. And if you’re wearing John Lobb loafers, just smile and know your fellow members may feel you are now the known unknown member. But aren’t we all at some point in our lives? See you at the meeting and tell your friends to become members of our organization.

As co-chairs of the planning committee, it is our great pleasure to invite you to the 2026 Annual Meeting of the American Venous Forum (AVF), to be held in Denver, Colorado, February 28 – March 4, 2026.

This year’s meeting continues the AVF’s tradition of outstanding scientific content and a collegial atmosphere dedicated to advancing education, collaboration, and innovation in the care of venous and lymphatic disease.

We are proud to welcome attendees from all specialties involved in the management of venous and lymphatic disorders, including vascular surgery, interventional radiology, vascular medicine, dermatology, hematology, and beyond. The program will again provide a balanced mix of deep/superficial venous and lymphatic disease topics designed to enhance both the scientific foundation and the clinical practice of all attendees.

Highlights of the 2026 meeting include:

• Doctors’ Lounge Case Discussions – interactive sessions exploring real-life, challenging clinical scenarios with expert input.
• Pulmonary Embolism (PE) Session – new this year, focused on practical insights into the diagnosis and management of pulmonary embolism and the steps involved in developing and optimizing a PERT program.
• Advanced Practice Provider (APP) Program – an outstanding weekend program featuring practical education and collaboration for advanced practice professionals.
• Physician-in-Training Program – comprehensive and hands-on didactic sessions offering a strong foundation in venous and lymphatic disease for residents and fellows, or early-career professionals.
• Case Competitions and Electronic Posters – opportunities to present and discuss innovative approaches, with recognition for top abstracts and scientific contributions.
• International Sessions – numerous opportunities throughout the meeting highlighting global perspectives and participation from experts representing many countries.

The AVF Annual Meeting remains the leading multi-disciplinary forum for sharing research, refining best practices, and strengthening the community of clinicians dedicated to venous and lymphatic health. We warmly invite you to join us in Denver for an inspiring and educational experience in the Mile-High City.

We look forward to welcoming you!

AVF has made a significant investment in planning a meaningful, interactive program specifically for APPs during the upcoming Annual Meeting in Denver. Key activities include:

• APP Abstract Sessions– For the first time ever, your colleagues will present groundbreaking research from the APP perspective, covering everything from innovative wound care approaches to cutting-edge PERT implementations.
• Joint Sessions with Physicians- in- Training– Collaborative learning at its finest, including hands-on ultrasound training with live patients and expert-led sclerotherapy workshops.
• Evidence-based Focus– From VTE management and metabolic syndrome’s role in venous disease to advanced lymphedema treatments, we’re covering the clinical updates that will transform your practice.
• Community Impact– Join our inaugural Day of Service, connecting Denver patients directly with venous experts while giving back to the community.

The program stretches over two calendar days, February 28 and March 1, 2025. Attendees will have numerous opportunities to broaden their skills and expertise.

February 28 Highlights

• VTE & PERT Sessions – Master the new era of PE management and build effective PERT pathways.
• Medical Optimization Deep Dive – Target modifiable risks in chronic venous disease and optimize antithrombotic therapy.
• Day of Service – Community outreach that makes a real difference.

March 1 Highlights

• Comprehensive Wound Care – Advanced techniques and evidence-based approaches.
• APP & PIT Joint Hands-on Session – Interactive learning with the latest technologies.
• Sclerotherapy Mastery – Learn from the experts.
• Leg Swelling & Lymphedema – From updated CEAP criteria to advanced treatment options.

We appreciate the involvement of the APP Program Planning Committee:

• Karen Bauer, DNP, FNP-C
• Suzanna Fitzpatrick, DNP, PhD-C, ACNP-BC, FNP-BC
• Kathleen Ozsvath, M.D., FACS
• Kristan Probeck, CRNP
• Sarah Rosenberger, ACNP-BC

Mark your calendars for the International Session on Tuesday, March 3rd, from 3:15 PM to 4:15 PM. Moderated by Rashad Bishara, MD and Steve Elias, MD this session is a must-attend, featuring a keynote, a lively debate on perforators, and presentations of recent, impactful publications from International Committee members.

Keynote Focus on NIVL Patients

The session kicks off with a keynote lecture from Cees Wittens, MD at 3:15 PM. His talk, “Improving selection of treating ‘symptomatic’ NIVL patients. Preventing inappropriate care,” promises to provide critical insights into patient selection and optimizing care for non-invasive venous lab (NIVL) patients.

Perforator Debate & Discussion

Next, from 3:25 PM to 3:45 PM, a stimulating debate and discussion will focus on perforators in C5 & C6 patients. This segment features 3 expert perspectives on managing perforating veins in advanced chronic venous disease stages:

• Alvaro Orrego, MD argues that IP (incompetent perforators) should be targeted and ablated by thermal or glue.
• Paola Ortiz, MD suggests that IP could be closed as a side product of ultrasound-guided foam sclerotherapy (UGFS) around the ulcer.
• Lowell Kabnick, MD proposes that IP could be ignored until deep venous obstruction and superficial venous reflux have been treated.

A discussion period will follow, giving attendees a chance to weigh in on these different management strategies.

Recent Publications and Case Presentations

The final segment, running from 3:45 PM to 4:13 PM, will showcase recent publications from International Committee members presented in a case-based format. Each presentation will allow 2 minutes to present the case followed by 5 minutes for discussion. The presented topics include:

• Tomasz Urbanek, MD (3:45 PM – 3:52 PM): Staged or Simultaneous Varicose Vein Treatment After Saphenous Vein Ablation.
• Anelise Rodrigues, MD (3:52 PM – 3:59 PM): Pigmentation after Foam or Cryo-laser Cryo-sclerotherapy for Lower Limb Reticular Veins: A Within-patient Trial.
• Alejandro Gonzalez Ochoa, MD (3:59 PM – 4:06 PM): Conservative Treatments Effectiveness on Chronic Venous Disease Symptoms and Quality of Life in Patients with Obesity: Results from the VeinStep Observational Study.
• Takaya Murayama, MD (4:06 PM – 4:13 PM): Efficacy of Direct Radiofrequency Ablation System for Varicose Veins and Branch Varicosities.

The session will conclude with Closing Remarks at 4:13 PM.

Don’t miss this opportunity to engage with leading international experts and the latest research!