The Veineo® procedure

Endovenous radiofrequency ablation

Chronic venous insufficiency, or venous reflux, refers to the disruption of normal blood flow from the veins back to the heart, resulting in pooling (stasis) and thus venous hypertension. The term is sometimes used interchangeably with “varicose veins” in common parlance, but this is somewhat misleading. Although varicose veins can lead to chronic venous insufficiency if left untreated, CVI can also develop idiopathically or in connection with various conditions, such as deep vein thrombosis (postphlebitic syndrome), pelvic tumours, or leg muscle weakness. Moreover, these issues can prove mutually exacerbative: for example, perforating vein insufficiency has been linked to post-treatment recurrence of superficial varicose veins, and some studies even suggest that venous reflux may be an independent risk factor for DVT.

Chronic venous insufficiency is nothing new: research on the leg veins dates as far back as 1550 BC, and CVI has an estimated point prevalence of around 20-25% in women and 10-15% in men over the age of 15. While patients often initially seek treatment for cosmetic reasons (telangiectasia, varicose veins, hyperpigmentation), the condition can cause a variety of potentially debilitating symptoms ranging from pain, oedema, and fatigue to ulceration and haemorrhage.

Minimally invasive treatments for varicose veins have generated considerable interest in recent years. Whereas injection sclerotherapy was the most widely available option until the early 2000s, practitioners now have a variety of alternatives at their disposal, ranging from foam sclerotherapy to laser ablation to microphlebectomies.

The Veineo® procedure uses the principle of radiofrequency thermocoagulation to treat symptoms of CVI safely and effectively. A thin, flexible catheter is inserted into the vein, and high-energy (4 MHz) radio waves are transmitted to the tip, which ablates the vein walls and seals the vein along its entire length. The procedure can be performed in a day-case or outpatient setting; it causes minimal discomfort and allows patients to resume their normal activities almost immediately.

1. Under ultrasound guidance, puncture the vein using the appropriately sized introducer needle, and then insert the guide wire.

2. Position the dilator and sheath over the guide wire, then remove the guide wire and the dilator, leaving the sheath in place. 

3. Insert the catheter into the vein through the sheath, 1-2 cm from the junction.

4. Inject tumescent anaesthesia under ultrasound guidance, taking care to surround the entire length of the catheter. Recheck catheter position before proceeding.

5. Press the foot pedal to begin applying radiofrequency energy. Withdraw the catheter one marking at a time, following the generator’s visual and auditory signals.

6. Upon reaching the triple (red-blue-red) marking, release the foot pedal. Withdraw the sheath completely while holding the catheter in place. 

7. Continue treatment until the second and final red-blue-red marking emerges.

Foam sclerotherapy for saphenous veins

Foam sclerotherapy is another established method of treating varicose veins without surgery.
Our triple-lumen KAVS3L catheters are an excellent non-thermal, non-tumescent solution for closing saphenous veins.

Viridex RF® for telangiectasia

Chronic venous insufficiency can also manifest as telangiectasia, otherwise known as spider veins. Click here to discover the Viridex®RF system, which uses specially designed microneedles to treat spider veins and other dermatological conditions via radiofrequency thermocoagulation.