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KEY FACTS
Terminology
Preprocedure
Procedure
Post Procedure
TERMINOLOGY
Definitions
- Endovenous thermal ablation (EVTA): Procedure involving internal thermal energy delivery to vein wall
- Vein irreversibly occludes, eventually fibroses
- Used to eliminate incompetent superficial truncal veins responsible for superficial venous insufficiency
- Laser (differing wavelengths) or radiofrequency energy
- Superficial veins: Veins of lower extremity superficial to fascia that surrounds muscular compartment
- Includes truncal veins
- Great saphenous vein (GSV)
- Small saphenous vein (SSV)
- Includes anastomoses connecting GSV/SSV
- Vein of Giacomini: Posteromedial branch of GSV
- Arises at saphenofemoral junction (SFJ); connects to SSV
- Anterior thigh tributary (ATT)
- Arises at SFJ; courses over anterior thigh
- Vein of Giacomini: Posteromedial branch of GSV
- Also includes innumerable venous tributaries known as collecting veins
- Includes truncal veins
- Superficial venous insufficiency: Usually caused by primary degenerative disease of superficial vein wall
- Leads to venous reflux/chronic venous hypertension
- Venous reflux: Retrograde flow that occurs within veins; defective valves fail to prevent flow reversal
- Clinically significant reflux lasts for > 0.5-1.0 seconds following release of compression on muscular mass below vein
- CEAP classification: Clinical status, etiology, anatomy, and pathophysiology
- Summarizes disease state in chronic venous disease based on physical observations of disease severity
- Helps report clinical success of intervention
- Venous severity score (VSS) is additional means of grading spectrum of disease severity
- Endovenous thermal ablation (EVTA): Procedure involving internal thermal energy delivery to vein wall
PREPROCEDURE
Indications
Contraindications
Preprocedure Imaging
Getting Started
PROCEDURE
Patient Position/Location
Procedure Steps
Alternative Procedures/Therapies
POST PROCEDURE
Things to Do
Postprocedure Imaging
OUTCOMES
Problems
Complications
Expected Outcomes
Selected References
- Morrison N et al: Randomized trial comparing cyanoacrylate embolization and radiofrequency ablation for incompetent great saphenous veins (VeClose). J Vasc Surg. 61(4):985-94, 2015
- Todd KL 3rd et al: The VANISH-2 study: a randomized, blinded, multicenter study to evaluate the efficacy and safety of polidocanol endovenous microfoam 0.5% and 1.0% compared with placebo for the treatment of saphenofemoral junction incompetence. Phlebology. 29(9):608-18, 2014
- Kerver AL et al: The surgical anatomy of the small saphenous vein and adjacent nerves in relation to endovenous thermal ablation. J Vasc Surg. Epub ahead of print, 2012
- Lewis M et al: Advantages of blood pool contrast agents in MR angiography: A pictorial review. J Med Imaging Radiat Oncol. 56(2):187-91, 2012
- Gloviczki P et al: The care of patients with varicose veins and associated chronic venous diseases: clinical practice guidelines of the Society for Vascular Surgery and the American Venous Forum. J Vasc Surg. 53(5 Suppl):2S-48S, 2011
- Haqqani OP et al: Great saphenous vein patency and endovenous heat-induced thrombosis after endovenous thermal ablation with modified catheter tip positioning. J Vasc Surg. 54(6 Suppl):10S-7S, 2011
- Gale SS et al: A randomized, controlled trial of endovenous thermal ablation using the 810-nm wavelength laser and the ClosurePLUS radiofrequency ablation methods for superficial venous insufficiency of the great saphenous vein. J Vasc Surg. 52(3):645-50, 2010
- Khilnani NM et al: Multi-society consensus quality improvement guidelines for the treatment of lower-extremity superficial venous insufficiency with endovenous thermal ablation from SIR, CIRSE, ACP and CIRA. J Vasc Interv Radiol. 21(1):14-31, 2010
- O'Donnell TF: The role of perforators in chronic venous insufficiency. Phlebology. 2010 Feb;25(1):3-10. Review. Erratum in: Phlebology. 25(4):214, 2010
- Almeida JI et al: Radiofrequency endovenous ClosureFAST versus laser ablation for the treatment of great saphenous reflux: a multicenter, single-blinded, randomized study (RECOVERY study). J Vasc Interv Radiol. 20(6):752-9, 2009
- Gohel MS et al: Radiofrequency ablation for uncomplicated varicose veins. Phlebology. 24 Suppl 1:42-9, 2009
- Ravi R et al: Endovenous thermal ablation of superficial venous insufficiency of the lower extremity: single-center experience with 3000 limbs treated in a 7-year period. J Endovasc Ther. 16(4):500-5, 2009
- Fan CM et al: Endovenous laser ablation: mechanism of action. Phlebology. 23(5):206-13, 2008
- Frasier K et al: Minimally invasive vein therapy and treatment options for endovenous heat-induced thrombus. J Vasc Nurs. 26(2):53-7, 2008
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References
Tables
Tables
KEY FACTS
Terminology
Preprocedure
Procedure
Post Procedure
TERMINOLOGY
Definitions
- Endovenous thermal ablation (EVTA): Procedure involving internal thermal energy delivery to vein wall
- Vein irreversibly occludes, eventually fibroses
- Used to eliminate incompetent superficial truncal veins responsible for superficial venous insufficiency
- Laser (differing wavelengths) or radiofrequency energy
- Superficial veins: Veins of lower extremity superficial to fascia that surrounds muscular compartment
- Includes truncal veins
- Great saphenous vein (GSV)
- Small saphenous vein (SSV)
- Includes anastomoses connecting GSV/SSV
- Vein of Giacomini: Posteromedial branch of GSV
- Arises at saphenofemoral junction (SFJ); connects to SSV
- Anterior thigh tributary (ATT)
- Arises at SFJ; courses over anterior thigh
- Vein of Giacomini: Posteromedial branch of GSV
- Also includes innumerable venous tributaries known as collecting veins
- Includes truncal veins
- Superficial venous insufficiency: Usually caused by primary degenerative disease of superficial vein wall
- Leads to venous reflux/chronic venous hypertension
- Venous reflux: Retrograde flow that occurs within veins; defective valves fail to prevent flow reversal
- Clinically significant reflux lasts for > 0.5-1.0 seconds following release of compression on muscular mass below vein
- CEAP classification: Clinical status, etiology, anatomy, and pathophysiology
- Summarizes disease state in chronic venous disease based on physical observations of disease severity
- Helps report clinical success of intervention
- Venous severity score (VSS) is additional means of grading spectrum of disease severity
- Endovenous thermal ablation (EVTA): Procedure involving internal thermal energy delivery to vein wall
PREPROCEDURE
Indications
Contraindications
Preprocedure Imaging
Getting Started
PROCEDURE
Patient Position/Location
Procedure Steps
Alternative Procedures/Therapies
POST PROCEDURE
Things to Do
Postprocedure Imaging
OUTCOMES
Problems
Complications
Expected Outcomes
Selected References
- Morrison N et al: Randomized trial comparing cyanoacrylate embolization and radiofrequency ablation for incompetent great saphenous veins (VeClose). J Vasc Surg. 61(4):985-94, 2015
- Todd KL 3rd et al: The VANISH-2 study: a randomized, blinded, multicenter study to evaluate the efficacy and safety of polidocanol endovenous microfoam 0.5% and 1.0% compared with placebo for the treatment of saphenofemoral junction incompetence. Phlebology. 29(9):608-18, 2014
- Kerver AL et al: The surgical anatomy of the small saphenous vein and adjacent nerves in relation to endovenous thermal ablation. J Vasc Surg. Epub ahead of print, 2012
- Lewis M et al: Advantages of blood pool contrast agents in MR angiography: A pictorial review. J Med Imaging Radiat Oncol. 56(2):187-91, 2012
- Gloviczki P et al: The care of patients with varicose veins and associated chronic venous diseases: clinical practice guidelines of the Society for Vascular Surgery and the American Venous Forum. J Vasc Surg. 53(5 Suppl):2S-48S, 2011
- Haqqani OP et al: Great saphenous vein patency and endovenous heat-induced thrombosis after endovenous thermal ablation with modified catheter tip positioning. J Vasc Surg. 54(6 Suppl):10S-7S, 2011
- Gale SS et al: A randomized, controlled trial of endovenous thermal ablation using the 810-nm wavelength laser and the ClosurePLUS radiofrequency ablation methods for superficial venous insufficiency of the great saphenous vein. J Vasc Surg. 52(3):645-50, 2010
- Khilnani NM et al: Multi-society consensus quality improvement guidelines for the treatment of lower-extremity superficial venous insufficiency with endovenous thermal ablation from SIR, CIRSE, ACP and CIRA. J Vasc Interv Radiol. 21(1):14-31, 2010
- O'Donnell TF: The role of perforators in chronic venous insufficiency. Phlebology. 2010 Feb;25(1):3-10. Review. Erratum in: Phlebology. 25(4):214, 2010
- Almeida JI et al: Radiofrequency endovenous ClosureFAST versus laser ablation for the treatment of great saphenous reflux: a multicenter, single-blinded, randomized study (RECOVERY study). J Vasc Interv Radiol. 20(6):752-9, 2009
- Gohel MS et al: Radiofrequency ablation for uncomplicated varicose veins. Phlebology. 24 Suppl 1:42-9, 2009
- Ravi R et al: Endovenous thermal ablation of superficial venous insufficiency of the lower extremity: single-center experience with 3000 limbs treated in a 7-year period. J Endovasc Ther. 16(4):500-5, 2009
- Fan CM et al: Endovenous laser ablation: mechanism of action. Phlebology. 23(5):206-13, 2008
- Frasier K et al: Minimally invasive vein therapy and treatment options for endovenous heat-induced thrombus. J Vasc Nurs. 26(2):53-7, 2008
