Overview of Endovenous Thermal Ablation of Varicose Veins

V ar ic os e V ei ns Endovenous interventions have transformed the treatment of varicose veins during the past decade. Interest in minimally invasive endovenous thermal ablation of the saphenous vein has substantially increased due to multiple reasons. Both radiofrequency ablation (RFA) and endovenous laser therapy (EVLT) can be performed as an office procedure; they are less invasive and usually less painful than conventional open surgical stripping and appear to be equally as effective. In addition, there is apparent benefit of earlier return to work and less temporary decrease in quality of life. Public awareness of varicose veins and venous disease has increased considerably, in part because of activities of the American Venous Forum and the American College of Phlebology, but also because of increasing public advertisement of minimally invasive techniques by the medical industry. Informed patients seeking medical help for aching legs with unsightly veins or venous ulcers request RFA or EVLT for treatment of venous disease. In a recent issue of Endovascular Today, leaders of the field expressed their opinion of currently used techniques for varicose veins including RF, EVLT, endovenous chemical ablation with ultrasound-guided foam sclerotherapy, as well as the conventional open surgery of saphenous stripping and high ligation.1 This article reviews currently used endovenous thermal treatments for saphenous vein ablation in patients with varicose veins and presents the most recent results. We also provide an insight of what is on the horizon from the medical industry to improve efficacy, expand indications, and decrease complications of these procedures.