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.
Advantages for patients
- Fast, minimally invasive outpatient procedure
- Offers rapid relief from symptoms
- No risk of hyperpigmentation
- No post-treatment wound care
- Return to regular activities quickly
Advantages for practitioners
- Flexible, unbreakable catheters allow easy manoeuvrability through tortuous veins
- Catheter markings offer visual cues for added convenience
- Multiple catheter sizes available for treating vessels of different diameters
- Both legs can be treated in a single session
- 3mm thermal radius prevents damage to surrounding tissue
- Can be used on saphenous veins as well as superficial collateral and perforating veins
- No risk of complications such as DVT, paraesthesia or ecchymosis
Ablation using radiofrequency (F Care Systems) is a safe and minimally invasive procedure. The catheter can easily be localised using ultrasound and followed from ankle to groin. The procedure is usually done on an outpatient basis, under local anaesthesia and completed within an hour. Only a small nick in the skin is required to insert the catheter which does not need stitches. This procedure leaves virtually no scars. Cosmetic result is much appreciated by patients. Actual closure of the vein with heat is not painful. After treatment patients wear compression stockings but they may resume their normal activity immediately. Most ablation catheters cannot easily pass through a vessel with many turns and bends but the F Care Systems Veineo® catheters can take a turn without perforating the vein. On top of that the tip of the catheter can be bent to navigate through the vessel when a stenosis or a turn needs to be passed. Especially for the perforator vein ablation, the versatility and suppleness of the catheter is a great asset.
Dr. Sabrina Speybrouck, vascular surgeon, Aalst, Belgium
Treatment protocol for the RF ablation of saphenous veins
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.
Comparative analysis of five-year outcomes of lower extremity varicose vein therapy using monopolar and segmental radiofrequency ablation
Witold WOŹNIAK, Maciej KIELAR, R. Krzysztof MLOSEK, Piotr CIOSTEK
International Angiology 2018 December; 37(6):457-64
Comparison of Monopolar and Segmental Radiofrequency Ablation in the Treatment of Lower Limb Chronic Venous Insufficiency
Jun-Yi Ryan TAN, Zhiwen Joseph LO, Pravin LINGAM, Qiantai HONG, Enming YONG, Sadhana CHANDRASEKAR, Glenn Wei Leong TAN
ARC Journal of Surgery, Volume 4, Issue 3, 2018, PP 5-10, ISSN 2455-572X
DOI : 10.20431/2455-572X.0403002
Endovenous ablation of incompetent truncal veins and their perforators with a new radiofrequency system. Mid-term outcomes
Stavros Spiliopoulos, Vasiliki Theodosiadou, Athanasia Sotiriadi and Dimitrios Karnabatidis
Vascular OnlineFirst, December 12, 2014
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Veineo RF catheters
Unbreakable yet extraordinarily flexible—follow even the most tortuous veins with ease.
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.