The Symptoms-Varices-Pathophysiology classification of pelvic venous disorders: A report of the American Vein & Lymphatic Society International Working Group on Pelvic Venous Disorders
Mark H Meissner, Neil M Khilnani, Nicos Labropoulos, Antonios P Gasparis, Kathleen Gibson, Milka Greiner, Lee A Learman, Diana Atashroo, Fedor Lurie, Marc A Passman, Antonio Basile, Zaza Lazarshvilli, Joann Lohr, Man-Deuk Kim, Philippe H Nicolini, Waleska M Pabon-Ramos, Melvin Rosenblatt, Mark H Meissner, Neil M Khilnani, Nicos Labropoulos, Antonios P Gasparis, Kathleen Gibson, Milka Greiner, Lee A Learman, Diana Atashroo, Fedor Lurie, Marc A Passman, Antonio Basile, Zaza Lazarshvilli, Joann Lohr, Man-Deuk Kim, Philippe H Nicolini, Waleska M Pabon-Ramos, Melvin Rosenblatt
Abstract
As the importance of pelvic venous disorders (PeVD) has been increasingly recognized, progress in the field has been limited by the lack of a valid and reliable classification instrument. Misleading historical nomenclature, such as the May-Thurner, pelvic congestion, and nutcracker syndromes, often fails to recognize the interrelationship of many pelvic symptoms and their underlying pathophysiology. Based on a perceived need, the American Vein and Lymphatic Society convened an international, multidisciplinary panel charged with the development of a discriminative classification instrument for PeVD. This instrument, the Symptoms-Varices-Pathophysiology ("SVP") classification for PeVD, includes three domains-Symptoms (S), Varices (V), and Pathophysiology (P), with the pathophysiology domain encompassing the Anatomic (A), Hemodynamic (H), and Etiologic (E) features of the patient's disease. An individual patient's classification is designated as SVPA,H,E. For patients with pelvic origin lower extremity signs or symptoms, the SVP instrument is complementary to and should be used in conjunction with the Clinical-Etiologic-Anatomic-Physiologic (CEAP) classification. The SVP instrument accurately defines the diverse patient populations with PeVD, an important step in improving clinical decision making, developing disease-specific outcome measures and identifying homogenous patient populations for clinical trials.
Keywords: May Thurner syndrome; Pelvic pain; Renal nutcracker syndrome; Varicose veins; Venous insufficiency.
Copyright © 2021 The Authors. Published by Elsevier Inc. All rights reserved.
Source: PubMed