A mapping review of Pacific Vascular Symposium 6 initiatives

Abstract

Objective: The 2010 Pacific Vascular Symposium 6 (PVS6) brought venous disease content experts together with a goal of addressing critical issues collated together in the next decade with concrete plans to achieve these goals. This mapping review aims to provide a broader representation of how progress in critical issues of chronic venous disease has been made by extrapolating scientific publications related to the PVS6 initiatives.

Methods: We performed a mapping review identifying original or systematic review/meta-analysis articles related to PVS 6 initiatives (aims) that addressed one of the following key objectives: scales to measure chronic venous disease, effectiveness of interventional deep venous thrombus removal, development of a deep venous valve, and biomarkers related to venous disease. Searches were undertaken in PubMed, Ovid Medline, Cochrane Library, Embase (Elsevier), CINAHL (EBSCO), and Scopus. We extracted descriptive information about the studies and predefined variables for each specific aim, showing what and where research exists on the aims included.

Results: A total of 2138 articles were screened from 3379 retrieved articles from six electronic databases. We mapped 186 included articles, finding that the total number of publications significantly increased after the 2010 PVS6 meeting. Aim results were visually summarized. The largest body of data addressed catheter-based thrombus removal strategies for acute iliofemoral deep venous thrombosis. Primary research on artificial venous valves and venous biomarkers remained limited. No new post-thrombotic syndrome (PTS) score has been developed.

Conclusions: This mapping review identified and characterized the available evidence and gaps in our knowledge of chronic venous disease that exist visually, which may guide where more significant investments for the future should be targeted.

Keywords: Chronic venous disease; Mapping review; Pacific Vascular Symposium.

Fig 1

A, Number of publications by year before and after December 2010 (Pacific Vascular Symposium 6 [PVS6] publication date). B, Number of publications by year before and after December 2010 (PVS6 publication date) filtered by aim. CDT, Catheter-directed thrombolysis; PMT, pharmacomechanical thrombolysis.

Fig 2

A, Overall use of clinical and quality of life (QoL) scales uses by year. B, Clinical and QoL overall scale use and scales combinations by the number of patients enrolled. AVVQ, Aberdeen Varicose Vein Questionnaire; CEAP, Clinical (C), Etiological (E), Anatomical (A), and Pathophysiological (P); CIVIQ, Chronic Venous Insufficiency Quality of Life Questionnaire; EQ-5D, Euro QoL-5D instrument; SF-36, 36-item Short Form Survey; VCSS, Venous Clinical Severity Score; VEINES QOL, Venous Insufficiency Epidemiological and Economic Study - Quality of Life/Symptoms.

Fig 3

A, Location of deep venous thrombosis (DVT) for intervention, including iliofemoral, femoropopliteal, and inferior vena cava (IVC) and iliac segment before and after the Pacific Vascular Symposium 6 (PVS6) publication. B, Reported chronicity in DVT treatment, including acute, subacute, and chronic settings before and after the PVS6 publication. C, Use of catheter-directed thrombolysis (CDT)/ pharmacomechanical catheter-directed venous thrombolysis (PCDT), followed by pharmacomechanical thrombolysis (PMT)/ mechanical thrombectomy (MT), ultrasound-assisted catheter-directed thrombolysis (USCDT), and surgical thrombectomy and hybrid techniques for DVT treatment before and after the PVS6 publication. D, Use of adjunct procedures for DVT treatment before and after the PVS6 publication.

Fig 4

Artificial venous valve (AVV) study type, indication, preclinical and clinical valve assessment, and anticoagulation reported use. CFD, Computer fluid dymanics; CVI, chronic venous insufficiency; IVUS, intravascular ultrasound; PTS, post thrombotic syndrome.

Fig 5

A, Study types, indication, and the number of patients enrolled in chronic venous disease (CVD) research. B, Subgroup classification of the reported biomarkers in CVD research. C, Most common biomarkers associated with CVD and post thrombotic syndrome (PTS). D, Reported biomarker association or prognosis findings in patients with CVD, deep venous thrombosis (DVT), PTS. CS, Clinical study; NRCT, non-randomized observational study; RCT, randomized clinical trial; VV, varicose veins.

Supplementary Fig 1

Flow diagram of the search methodology. PRISMA, Preferred Reporting Items for Systematic Reviews and Meta-Analyses.

Supplementary Fig 2

A, Author country origin of the included articles. B, Selective author distribution in America. C, Selective author distribution in Europe. D, Selective author distribution in Asia. UK, United Kingdom; USA, United States.

Supplementary Fig 3

Main pathological protein clusters associated with inflammation, chronic venous disease (CVD), thrombosis, and skin changes.

Supplementary Fig 4

Visual summaries generated showing the aggregate data extracted for each specific aim. We show the differences in the degrees of connectedness as an association parameter on our predetermined areas (aims) summarizing the relationship between the studies by direct citation. A, Visualization for included articles in aim 1 by direct citation of the Pacific Vascular Symposium 6 (PVS6) articles and in between them. B, Visualization for included articles in aim 2. C, Visualization for included articles in aim 3. D, Visualization for included articles in aim 4.