Thermal Laser Endovenous  (LEV) or Radio Frequency (RF) treatments became recently reimbursed by insurance companies, as deemed effective, less expensive, more simple in implementation, and  very beneficial in terms of abscenteeism .

The catheter used will weld the straight path of a truncal dilated vein (dotted in the example) that no longer works and switch this venous axis  « off ».   The rest of the visible network involved downstream must be removed by phlebectomy (knee and tibia) These thermic ablation procedures are effective in the long term and can replace the classic stripping when the involved network is ‘simple’, permeable, scarless , and not too much on the surface , because of the potential cutaneous side effects due to the thermal release.

At the level of the superficial and deep network junctions (inguinal folds - popliteal area knee), only the hemodynamic and anatomical criteriae will lead to the most indicated action or feasibility . The situation must be assessed in order to « map » in same way as with surgery.

The potential of Endoluminal techniques is huge . It is possible to treat young patients , but also elderly people (SEE the                          ,              with    overweight, venous ulcers, patients at general risk,  Keloids tendency , or simply these persons who fear to be « operated upon» or who fear anesthesia.  The procedure  is done without interruption of anti-clotting drug treatment.

One of the limitations is the access and the eradication of the ramifications that may accompany the main trunk (see image ultrasound below) in one gesture, which is not the case in well conducted surgery. Remaining branches bear the risk of « recurrence » in the medium and long term, and may lead to additional treatments ( phlebectomy - foam sclerosing - Redo…). Another limiting factor is the configuration and mode of junction with the venous system deep, e.g. multiple axes, aneurysmal and access.

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At 3 months, the echography  shows the regression of the calibre of the trunk that fed this fairly large varicose status.   Approximately in 1 year, it will be completely gone!

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