Joseph A. Ronsivalle, DO, FSIR; Suvranu Ganguli, MD
To access 4,300 diagnoses written by the world's leading experts in radiology, please log in or subscribe.Log inSubscribe
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
Also includes innumerable venous tributaries known as collecting 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
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
Related Anatomy
Loading...
Related Differential Diagnoses
Loading...
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
Also includes innumerable venous tributaries known as collecting 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
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
STATdx includes over 200,000 searchable images, including x-ray, CT, MR and ultrasound images. To access all images, please log in or subscribe.