The Ashford & St Peter’s Venous Classification System (ASPVCS) is a new reporting system developed at Ashford and St Peter’s Hospitals NHS Foundation Trust by the vascular team. There has been no reporting system in the scientific literature to quantify and report anatomical complexity that surgeons face while performing varicose vein minimally invasive surgery such as radiofrequency or laser therapy. This lack of standardisation of reporting has marked the varicose vein surgery despite the high number of procedures performed each year in the NHS (over 24700 cases in 2012-13 [1] ).
ASPVCS is constructed using four domains: number of truncal veins treated, number of zone avulsions, number of major anatomical variations (e.g. significant bending), and number of minor anatomical variation (e.g. need for side pressure). ASPVCS classification was found to correlate well with total number of main vein trunks and number of major anatomical variations. ASPVCS scoring was presented at the Association of Surgeons in Training (ASiT) conference 2016. [2]
ABSTRACT:
Association of Surgeons in Training Conference 2016
Abstract: 627; Evaluating a new intraoperative classification system for reporting complexity level in endovenous procedures – the ASPVCS classification
Objective: to construct new classification for reporting complexity in endovenous procedures -the Ashford & St Peter’s Venous Classification System (ASPVCS).
Method – ASPVCS is constructed using four domains: number of truncal veins treated, number of zone avulsions, number of major anatomical variations (e.g. significant bending), and number of minor anatomical variation (e.g. need for side pressure). Total operative duration used as proxy for level of complexity. Effect of each domain on duration quantified using correlation and Regression analysis.
Results – ASPVCS classification applied on 69 patients undergoing 82 procedures. Median age was 64. Number of main truncal veins treated was 1 (55%), 2 (25%), 3 (16%) and 4 (4%). Major anatomical variations found in 45% of cases. Average procedure duration was 44 min (13-155 min). Significant correlation found between operative duration and total number of main vein trunks (0.62. p<.0001) and number of major anatomical variations (0.36. p < 0.05). Multiple regression analysis showed all domains apart from minor anatomy variation do explain variance in operative duration (R2 = .55, R2Adjusted = .52, p < .05).
Conclusion – ASPVCS scoring can be used in reporting and predicating outcome for intraoperative anatomical variation and is correlated to level of procedure complexity.
References[edit]
- Jump up ^ “Vein surgery in the UK”. Retrieved 27 October 2013.
- Jump up ^ “ASiT Conference 2016”.