The effect of hypoxia on intra-ocular, mean arterial, retinal venous and ocular perfusion pressures Issue title: High altitude hypoxia is linked to decreased blood oxygen saturation with a related increase of Endothelin-1 ET-1 blood plasma levels. As a consequence of such elevated ET-1 levels, alterations of retinal venous and ocular perfusion pressures are suspected. To measure the effect of hypoxia on intra-ocular pressure, mean arterial pressure, retinal venous pressure and to calculate ocular perfusion pressure.
Recurrent superficial thrombophlebitis; or Severe and persistent pain and swelling interfering with activities of daily living and requiring chronic analgesic medication. Surgical ligation including subfascial endoscopic perforator vein surgery SEPS or endovenous ablation procedures are considered medically necessary for the treatment of incompetent perforating veins with vein diameter measured by recent ultrasound of 3.
Initially, endovenous ablation therapy of the first vein and of the second and subsequent veins in each affected extremity is considered medically necessary when criteria are met.
In order to authorize additional endovenous ablation, there should be documentation that the member continues to have symptoms and ultrasound showing persistent junctional reflux.
Additional endovenous ablation therapy may also be necessary for treatment of accessory saphenous veins as noted above. These procedures are considered cosmetic for all other indications.
The term endovenous catheter ablation EVCA is a non-specific term that refers to the several catheter based minimally invasive alternatives to surgical stripping such as radiofrequency endovenous occlusion VNUS procedure and endovenous laser ablation of the saphenous vein ELAS.
In assessing the medical necessity of EVCA, reference should be made to the specific technique that is being employed. Aetna considers liquid or foam sclerotherapy endovenous chemical ablation e.
Since ultrasound-monitored or duplex-guided techniques for sclerotherapy have not been shown to definitively increase the effectiveness or safety of this procedure, these tests are only considered medically necessary when initially performed to determine the extent and configuration of varicose veins.
Ultrasound- or radiologically guided or monitoring techniques are of no proven value when performed solely to guide the needle or introduce the sclerosant into the varicose veins. The number of medically necessary sclerotherapy injection sessions varies with the number of anatomical areas that have to be injected, as well as the response to each injection.
A set of injections is defined as multiple sclerotherapy injections during a treatment session.
Ambulatory phlebectomy or transilluminated powered phlebectomy is considered experimental and investigational for treatment of junctional reflux as these procedures have not been proven to be effective for these indications. Ambulatory phlebectomy and the TriVex system is considered cosmetic for veins less than 2.
Transilluminated powered phlebectomy has not been proven to be superior to other methods of varicose vein removal.
Therefore, the TriVex procedure should be billed as any other varicose vein removal procedure. Initially, up to two multiple stab phlebectomy incisions in each affected extremity i.
Additional multiple stab phlebectomy incisions are considered medically necessary for persons with persistent or recurrent symptoms. A set of stab phlebectomy incisions is defined as multiple stab phlebectomy incisions during a treatment session.
Aetna considers photothermal sclerosis also referred to as an intense pulsed light source, e. YAG laser has been shown to be effective for the treatment of telangiectasias and reticular veins, treatment of these small veins is considered cosmetic.
Aetna considers endomechanical or mechanicochemical ablation MOCA e.
Aetna considers valvular reconstruction medically necessary for chronic venous insufficiency. Aetna considers micronized purified flavonoid fraction for the treatment of varicose veins experimental and investigational because its effectiveness has not been established.
Aetna considers the VeinGogh Ohmic Thermolysis System experimental and investigational because of insufficient evidence of its effectiveness.
Aetna considers the use of medical adhesive also referred to as cyanoacrylate superglue, n-butyl-cyanoacrylate e. Aetna considers polymorphism genotyping of matrix metalloproteinases genes e. Aetna considers synthetic matrix metalloproteinases inhibitors for the treatment of varicose veins experimental and investigational because its effectiveness has not been established.
For endoluminal cryoablation also referred to as cryofreezing, cryostripping, cryosurgery, cryotherapy for varicose veins, see CPB - Cryoablation. Background Varicose veins are a common condition. In most persons, varicose veins do not cause symptoms other than poor cosmesis.
Varicose vein surgery is one of the most commonly performed cosmetic procedures in the United States.Analysis of Anesthesia-related Medical Disputes in the Period Using the Korean Society of Anesthesiologists Database Using the Korean Society of Anesthesiologists database of anesthesia.
Ultrasound scanners came into different categories according to their performance and price.
From the early s, scanners have started to move into clinics and private offices and there is a trend to decentralise ultrasound services all over the world.
The following data were gathered from the anesthesiology intra-operative record: the use of the Trendelenburg position, ASA classification level along with emergency status, the utilization of rapid-sequence induction and cricoid pressure, duration of surgery in minutes, fluid intake, fluid output, and administration of intravenous glycopyrrolate with anesthesia induction.
The American College of Cardiology (ACC) and the American Heart Association (AHA) are committed to the prevention and management of cardiovascular diseases through professional education and research for clinicians, providers, and patients.
Since , the ACC and AHA have shared a responsibility to. Anesthesiology congratulates Editor George A. Mashour, M.D., Ph.D., on being elected to the National Academy of Medicine.
Election to the Academy is considered one of the highest honors in the fields of health and medicine and recognizes individuals who have demonstrated outstanding professional achievement and commitment to service.
Number: Policy. Aetna considers the diagnosis and treatment of obstructive sleep apnea (OSA) in adults aged 18 and older medically necessary according to the criteria outlined below.