Thermal Techniques
Laser endoveineux – Radiofréquence
Laser and Radiofrequency.
Modern endovenous techniques of ablation
In addition to the ASVAL method developed at the Riviera Vein Institute, Dr. Pittaluga’s team has also contributed to the development of other modern techniques to treat patients whose disease is too advanced and where the saphenous vein is impossible to preserve. In these advanced cases the saphenous vein must unfortunately be removed. For this purpose, endovenous thermal ablation techniques using laser or radiofrequency technology have now replaced the old traditional surgical stripping in many countries around the world.
Endovenous laser or radiofrequency ablation techniques are performed under the same conditions of care and surgical environment as the ASVAL method (local anaesthesia, very rapid discharge, no post-operative care) with equally simple after-effects (no disability, resumption of work the next day in more than 90% of cases).
These 2 procedures are performed on an outpatient basis. Using ultrasound, the practitioner places an ablation catheter in the vein through a simple puncture. This catheter is powered either by radiofrequency energy or by laser energy, which heats the vein wall.
As heat is delivered, the diseased saphenous vein gradually closes without the need for aggressive removal, unlike traditional surgical stripping.
As the positioning of the ablation catheter is very precisely determined by ultrasound monitoring during the procedure, only the sickest part of the saphenous vein will be closed, which makes it possible to preserve the parts of the saphenous vein still healthy.
In the following weeks, the closed segment of saphenous vein will gradually disappear, naturally reabsorbed by the body.
The advantages
The advantages of these two minimally invasive endovenous ablation techniques
No hematoma
The saphenous vein is not stripped out as in traditional stripping: there is no hematoma.
Minimum pain
There is no tearing, no hematoma so there is little or no pain.
No incision
Fibers or probes are introduced by simple puncture: there is no incision.
Outpatient – short stay
The patient leaves the facility one hour after the procedure.
Wearing a compression stocking
The absence of tissue trauma allows for the short duration of the compression stocking (only a few hours).
No time off work
In the vast majority of cases, resumption of work is possible the following day.
Thus, even when the stage of varicose disease is advanced and the saphenous vein must be ablated, it is possible to propose a minimally invasive treatment, with endovenous ablation by laser or radiofrequency, without postoperative disability.
It is of course preferable not to reach this stage and to have the treatment done earlier so that the saphenous vein can be preserved.