Thermal ablation and concomitant phlebectomy
varicose, reflux
REFLUXING, REFLUX
Venous access of the refluxing trunk was obtained by ultrasound-guided puncture at the most distal point of reflux (not lower than mid-calf). Subsequently, a 5-Fr sheath was inserted over a guidewire. The laser fibre was then inserted through the sheath and the laser tip positioned 1–2 cm from the SFJ, distally from the inferior epigastric vein. Tumescent anaesthetic solution was injected under ultrasound guidance. After activation, the laser fibre was pulled back continuously, delivering approximately 60 J per cm vein. Laser wavelengths of 940, 980 or 1470 nm, and radial, tulip or bare fibre tips were used. Subsequently, phlebectomies were performed during the same procedure as described previously. The length of saphenous trunk treated with EVLA was noted as well as the total length of removed varicose tributaries.