Introduction The use of telemedicine services may be effective in the perioperative management of patients with varicose veins. Methods Over a seven-month period, patients with varicose veins were evaluated in the virtual clinic via two-way secure videoconferencing or the traditional clinic by the same physician provider. Data sources included institutional Vascular Quality Initiative registry and patient satisfaction surveys. Results Among a total of 121 patients with varicose veins who underwent endovenous catheter ablation of the saphenous vein, 20 patients (16.5%) chose the telemedicine clinic (Group A) and 101 patients (83.5%) chose the traditional clinic (Group B) for their perioperative management. Comparing Group A and Group B, the mean age was 59.2 ± 12.1 versus 59.6 ± 13.0, respectively ( p = 0.944); women were 75% versus 73.3%, respectively ( p = 0.872); African Americans comprised 5% versus 22.8%, while Caucasians comprised 95% versus 63%, respectively ( p = 0.049). Half of the telemedicine patients had multiple virtual visits for a total of 31 virtual encounters. Among telemedicine patients using SurveyMonkey®, 29 telemedicine encounters (93.5%) reported that their virtual visit is "Yes, definitely" or "Yes, somewhat" more convenient over traditional methods. All patients answered that they were able to communicate clearly with the provider, able to have their questions answered, and able to clearly hear and see the provider via telemedicine methods. Discussion Telemedicine services enable another means to deliver high-quality care for patients with venous disease in a safe and coordinated manner. Patients with varicose veins are highly satisfied with the use of telehealth services over the traditional healthcare delivery model.

No abstract

Objective: In-stent stenosis is a frequent complication of superficial femoral artery (SFA) endovascular intervention and can lead to stent occlusion or symptom recurrence. Arterial duplex ultrasound stent imaging (ADSI) can be used in the surveillance for recurrent stenosis; however, its uniform application is controversial. In this study, we aimed to determine, in patients undergoing SFA stent implantation (SI), whether surveillance with ADSI yielded a better outcome than in those with only anklebrachial index (ABI) follow-up.Methods: We performed a retrospective analysis of all patients undergoing SFA SI for occlusive disease at a tertiary care referral center between 2009 and 2016. The patients were divided into those with ADSI (ADSI group) and those with ABI follow-up only (ABI group). Life-table analysis comparing stent patency, major adverse limb event (MALE), limb salvage, and mortality between groups was performed.Results: There were 248 patients with SFA SI included, 160 in the ADSI group and 88 in the ABI group. Groups were homogeneous regarding clinical indication (claudication/critical limb ischemia, ADSI 39%/61% vs ABI 38%/62%; P ¼ .982) and TransAtlantic Inter-Society Consensus classification (A/B/C/D for ADSI 17%/45%/16%/22% and ABI 21%/43%/16%/20%; P ¼ .874). Primary patency (PP) was similar between groups at 12, 36, and 56 months (ADSI, 65%/43%/32%; ABI, 69%/34%/34%; P ¼ .770), whereas ADSI patients showed an improved assisted PP (84%/68%/54%) vs ABI (76%/38%/38%; P ¼ .008) and secondary patency (Fig 1). There was a greater freedom from MALE in the ADSI group (91%/76%/64%) vs the ABI group (79%/46%/46%; P < .001) at 12, 36, and 56 months of followup. ADSI patients were more likely to undergo an endovascular procedure as their initial post-SFA SI intervention (P ¼ .001), whereas ABI patients were more likely to undergo an amputation (P < .001; Fig 2).Conclusions: In SFA SI, patients with ADSI follow-up demonstrate an advantage in assisted PP and secondary patency and are more likely to undergo an endovascular reintervention. These factors likely effected a decrease in MALE, indicating the benefit of a more universal adoption of post-SFA SI follow-up ADSI.