SVP Classification for Pelvic Veins

The use of historical nomenclature for pelvic venous disorders fails to recognize the complex and interrelated pelvic venous circulation; contributes to misdiagnosis and poor treatment outcomes; and hinders clinical research.  The SVP (Symptoms-Varices-Pathophysiology)  instrument is designed to clarify the classification of pelvic venous disorders by defining homogenous patient populations.  The SVP instrument will facilitate clinical communication, allow treatment to be more precisely directed, and facilitate the development of patient-reported outcome measures and clinical trials.

The Symptoms-Varices-Pathophysiology (SVP) Classification of Pelvic Venous Disorders A Report of the American Vein & Lymphatic Society International Working Group on Pelvic Venous Disorders

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 upon a perceived need, the American Vein and Lymphatic Society (AVLS) convened an international, multidisciplinary panel charged with the development of a discriminative classification instrument for PeVD. This instrument, the “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 CEAP. 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."

Venous Classification Workbooks - COMING SOON

With the publication of the SVP venous classification system for pelvic veins comes the challenge of learning how to use the new system. The AVLS Education Committee and American Venous Forum (AVF) created the Venous Classification Workbooks for CEAP and SVP to help practically education and apply classifications in venous practices.

Instead of listening to a series of lectures and trying to apply the venous classification systems without guidance, the workbooks walk through not only what the system means but how to use it to improve your practice.

After reviewing the research and support for the CEAP or SVP classifications, the digital workbooks walk through a series of case studies. Each case study is interactive providing the learner the opportunity to classify the case themselves and correcting their classification when needed.

Once all the case studies are completed, the course offers a certificate for those who achieved an 80% pass rate and the opportunity for further education for those who did not.

The goal with these workbooks is to create an interactive, online learning experience allowing physicians to walk through and study the CEAP and SVP classification systems on their own time. Plus, apply what they learned through completing case studies.

Additionally, the AVLS is releasing the SVP Classification App to go alongside the SVP workbook and into practices to assist with using the SVP Classification system in every day patient encounters.

Appropriately applying venous classification systems is significant for future research and advocacy around venous disease.

The workbooks will be launched in Fall of 2021 and available as individual CEAP or SVP workbooks and as a bundle. The AVLS and AVF will be offering these for sale on their websites with special member pricing.

SVP Presentation from 2020 AVLS Annual Congress

SVP Classifier App

The use of historical nomenclature for pelvic venous disorders fails to recognize the complex and interrelated pelvic venous circulation; contributes to misdiagnosis and poor treatment outcomes; and hinders clinical research. The SVP (Symptoms-Varices-Pathophysiology) instrument is designed to clarify the classification of pelvic venous disorders by defining homogenous patient populations. The SVP instrument will facilitate clinical communication, allow treatment to be more precisely directed, and facilitate the development of patient-reported outcome measures and clinical trials.

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