CSH was at SIR 2022 in Boston!
I have to say, it was great to be back in person in Boston this week for one of my first in-person medical meetings since the pandemic. There really is nothing like the energy of being in person with clients and colleagues, and not to mention the better seafood than we get in land-locked Toronto!
On top of the excitement of finally being live and in-person at an event hall, I am excited to report that the hot topic of SIR 2022 is one that has implications for specialties well beyond interventional radiology. It is clear that venous therapies are poised to completely change the standard of care for DVT, which affects nearly a million Americans each year 10% of whom may die from the condition.
DOACs completely changed the field when introduced more than a decade ago. Before them patients had to use painful daily injections or the extra-inconvenient lab monitoring required for warfarin. However it has now become clear that even with appropriate medical therapy, a large subset of DVT patients suffer from long-term complications known as Post Thrombotic Syndrome (PTS). PTS can lead to chronic pain, disfiguring swelling, decreased mobility and chronic ulcers.
Venous interventions to prevent and treat PTS (either in the acute or chronic phase) are an evolving field and show tremendous promise. Multiple companies now have venous-specific stents on the market including Boston Scientific's Wallstent, Medtronic's Abre, Cook's Zilver Vena, and BD's Venovo. Uptake of these devices and interventions, however, has been inconsistent and the market is still in the growth phase.
The biggest challenges to venous interventions are limited clinical data, reimbursement, and clinical awareness. Conference attendees were excited about the potential for the C-TRACT trial which is still recruiting and would be the largest study to look at venous interventions for the treatment of PTS. They also discussed the challenges of inpatient vs. outpatient reimbursement and that inpatient treatment will be the standard of care for the near term.
As a non-IR, I was most impressed by the potential to treat PTS and the current lack of awareness of treatment options among us front-line clinicians. DVTs present frequently to emergency rooms, cancer clinics and primary care. However I'm sure that very few of us ever consider IR treatments as options, even for very large DVTs. For my own practice, I plan to advocate for my patients to get IR care when they present with a large DVT at risk of developing PTS.
Dr. Matt Runnalls
Chief Product Officer and ER Doctor