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Treatment Plan
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Negative for Reflux
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Venous Treatments
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Conservative Venous
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Active Venous Ulcers
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RFA
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Venaseal
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Right Leg
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GSV Prox Right Leg RFA/Varithena
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Foam? (Prox GSV R Leg RFA/Var)
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Tortuous/Short/SVT
• • •
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GSV Prox Right Leg Venaseal/Varithena
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Foam? (Prox GSV R Leg Ven/Var)
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Tortuous/Short/SVT
• • •
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GSV BK Right Leg Var
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AAV 36475 Right Leg RFA/Var
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AAV 36476 Right Leg RFA/Var
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Foam? (AAV 36475 R Leg RFA)
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Tortuous/Short/SVT
• • •
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Foam? (AAV 36476 R Leg RFA)
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Tortuous/Short/SVT
• • •
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AAV 36482 TX Right Leg Ven/Var
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AAV 36483 TX Right Leg Ven/Var
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Foam? (AAV 36482 R Leg Ven/Var)
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Tortuous/Short/SVT
• • •
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Foam? (AAV 36483 TX R Leg Ven/Var)
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Tortuous/Short/SVT
• • •
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PAV 36475 TX Right Leg (RFA)
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PAV 36476 TX Right Leg (RFA)
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Foam? (PAV 36475 TX R Leg RFA)
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Tortuous/Short/SVT
• • •
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Foam? (PAV 36476 TX R Leg RFA)
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Tortuous/Short/SVT
• • •
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PAV 36482 TX Right Leg Venaseal/Var
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PAV 36483 TX Right Leg Venaseal/Var
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Foam? (PAV 36482 R Leg Venaseal/Var)
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Tortuous/Short/SVT
• • •
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Foam? (PAV 36483 TX R Leg Venaseal/Var)
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Tortuous/Short/SVT
• • •
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SSV Right Leg (RFA/Var)
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SSV >= 5.0mm? (R RFA/Var)
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SSV <= 5.0mm? (R RFA/Var)
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Foam? (SSV >5 R Leg RFA/Var)
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Tortuous/Short/SVT
• • •
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Foam? (SSV <5 R Leg RFA/Var)
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Tortuous/Short/SVT
• • •
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SSV Right Leg (Ven/Var)
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SSV >= 5.0mm? (R Ven/Var)
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SSV <= 5.0mm? (R Ven/Var)
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Foam? (SSV >5 R Leg Ven/Var)
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Tortuous/Short/SVT
• • •
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Foam? (SSV <5 R Leg Ven/Var)
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Tortuous/Short/SVT
• • •
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VOG Right Leg (RFA)
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Foam? (VOG R Leg RFA)
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Tortuous/Short/SVT
• • •
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VOG Right Leg (Venaseal/Var)
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Foam? (VOG R Leg Ven/Var)
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Tortuous/Short/SVT
• • •
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ASV AK Right Leg (Var)
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ASV BK Right Leg (Var)
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Single Vein Sclero (R leg Sclero)
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Multi Vein Sclero (R leg Sclero)
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MC TV Right Leg (MC Sclero Single)
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MC TV Right Leg (MC Sclero Multi)
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LC TV Right Leg (MC Sclero Single)
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LC TV Right Leg (MC Sclero Multi)
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AC TV Right Leg (MC Sclero Single)
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AC TV Right Leg (MC Sclero Multi)
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PC TV Right Leg (MC Sclero Single)
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PC TV Right Leg (MC Sclero Multi)
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MT TV Right Leg (MC Sclero Single)
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MT TV Right Leg (MC Sclero Multi)
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AT TV Right Leg (MC Sclero Single)
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AT TV Right Leg (MC Sclero Multi)
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LT TV Right Leg (MC Sclero Single)
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LT TV Right Leg (MC Sclero Multi)
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PT TV Right Leg (MC Sclero Single)
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PT TV Right Leg (MC Sclero Multi)
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IP 1 Right Leg
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Perf Location
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IP 2 Right Leg
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Perf Location
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IP 3 Right Leg
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Perf Location
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Free Text
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Left Leg
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GSV Prox Left Leg (RFA)
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Foam? (Prox GSV L Leg RFA/Var)
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Tortuous/Short/SVT
• • •
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GSV Prox Left Leg Venaseal/Varithena
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Foam? (Prox GSV L Leg Ven/Var)
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Tortuous/Short/SVT
• • •
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GSV BK Left Leg (Var)
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AAV 36475 Left Leg (RFA)
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AAV 36476 Left Leg (RFA)
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Foam? (AAV 36475 L Leg RFA)
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Tortuous/Short/SVT
• • •
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Foam? (AAV 36476 L Leg RFA)
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Tortuous/Short/SVT
• • •
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AAV 36482 TX Left Leg (Venaseal)
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AAV 36483 TX Left Leg (Venaseal)
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Foam? (AAV 36482 L Leg Venaseal)
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Tortuous/Short/SVT
• • •
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Foam? (AAV 36483 TX L Leg Venaseal)
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Tortuous/Short/SVT
• • •
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PAV 36475 TX Left Leg (RFA)
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PAV 36476 TX Left Leg (RFA)
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Foam? (PAV 36475 TX L Leg RFA)
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Tortuous/Short/SVT
• • •
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Foam? (PAV 36476 TX L Leg RFA)
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Tortuous/Short/SVT
• • •
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PAV 36482 TX Left Leg Venaseal/Var
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PAV 36483 TX Left Leg Venaseal/Var
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Foam? (PAV 36482 L Leg Venaseal/Var)
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Tortuous/Short/SVT
• • •
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Foam? (PAV 36483 L Leg Venaseal/Var)
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Tortuous/Short/SVT
• • •
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SSV Left Leg (RFA/Var)
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SSV >= 5.0mm? (L RFA/Var)
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SSV <= 5.0mm? (L RFA/Var)
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Foam? (SSV >5 L Leg RFA/Var)
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Tortuous/Short/SVT
• • •
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Foam? (SSV <5 L Leg RFA/Var)
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Tortuous/Short/SVT
• • •
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SSV Left Leg (Ven/Var)
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SSV >= 5.0mm? (L Ven/Var)
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SSV <= 5.0mm? (L Ven/Var)
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Foam? (SSV >5 L Leg Ven/Var)
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Tortuous/Short/SVT
• • •
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Foam? (SSV <5 L Leg Ven/Var)
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Tortuous/Short/SVT
• • •
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VOG Left Leg (RFA)
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Foam? (VOG L Leg RFA)
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Tortuous/Short/SVT
• • •
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VOG Left Leg (Venaseal/Var)
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Foam? (VOG L Leg Ven/Var)
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Tortuous/Short/SVT
• • •
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ASV AK Left Leg (Var)
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ASV BK Left Leg (Var)
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Single Vein Sclero (L leg Sclero)
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Multi Vein Sclero (L leg Sclero)
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MC TV Left Leg (Sclero Single)
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MC TV Left Leg (Sclero Multi)
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LC TV left Leg (Sclero Single)
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LC TV Left Leg (Sclero Multi)
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AC TV Left Leg (Sclero Single)
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AC TV Left Leg (Sclero Multi)
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PC TV Left Leg (Sclero Single)
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PC TV Left Leg (Sclero Multi)
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MT TV Left Leg (Sclero Single)
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MT TV Left Leg (Sclero Multi)
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AT TV Left Leg (Sclero Single)
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AT TV Left Leg (Sclero Multi)
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LT TV Left Leg (Sclero Single)
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LT TV Left Leg (Sclero Multi)
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PT TV Left Leg (Sclero Single)
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PT TV Left Leg (Sclero Multi)
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IP 1 Left Leg
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Perf Location
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IP 2 Left Leg
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Perf Location
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IP 3 Left Leg
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Perf Location
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Free Text
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Conservative Plan
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Free Text
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