About this Research Topic
Endovenous ablation has emerged as a very effective therapeutic tool in managing the refluxing great and small saphenous veins. Initially employing an endovenous bipolar cautery to ablate the venous trunk, these techniques used in the decades of 1960’s-1990’s in Czechoslovakia and Russia, after the late 1990’s, technology changed to the much safer endovenous radiofrequency ablation (Venefit/Covidien) and also laser treatment with bare tip catheters (both approved by the FDA), including:
a. 810 nm (AngioDynamics Queensbury, NY)
b. 940 nm (Dornier MedTech Americas, Inc, Kennesaw, Ga)
c. 980 nm (Biolitec, Inc, East Longmeadow, Mass)
d. 1064 nm (Sharplan, Inc., NJ)
e. 1320 nm (CoolTouch, Roseville, Calif)
f. 1470 nm (Biolitec, Angiodynamics)
While radiofrequency catheters evolved from a tulip-like catheter tip to a coil heated by radiofrequency, allowing a much faster procedure, laser catheters have also evolved to a much higher wave length in an effort to increase effectiveness and safety. More recently a new generation of endovenous laser treatment with radial tip catheters ELVeS Radial™ (Biolitec, Angiodynamics) has been introduced.
Another currently used therapeutic modality for the treatment of varicose veins is foam sclerotherapy, usually ultrasound guided, which offers the advantage of non-thermal saphenous vein closure and thus can be done under local anesthesia, but currently offers lower closure rates than thermal venous ablation techniques.
Other endovenous treatment modalities include:
1. Mechanochemical endovenous ablation (MOCA™) with the ClariVein® device (Vascular Insights, Madison, CT, USA)
2. Glue closure a. VenaSeal™ closure system (Medronic) (glue system), b. Variclose (Biolas) (glue system)
3. Endovenous microwave ablation (EMA) (Microwave Intracavity Coagulation System; Shanghai Medical Electronics, Shanghai, China)
4. Sclerotherapy with the EASY-FOAM® kit or the Varisolve kit
5. Endovenous steam application with the VenoSteam™ (CERMAVEIN) device
It should be emphasized that treatment of perforator veins with some of the above devices is now routinely performed. Additionally, treatment of varicose veins following endovenous therapy of the main venous stems deserves special attention.
Most of the above methods have published short and/or long-term results. However, a detailed collection of articles outlining practical details of all these methods is lacking. The aim of this research topic is to provide an in-depth description of all endovenous ablation techniques, including case reports, methods articles and descriptions of techniques.
Keywords: Venous disease, venous insufficiency, reflux, saphenectomy, endovenous, vein ablation
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