J Cosmet Med.  2018 Jun;2(1):1-7. 10.25056/JCM.2018.2.1.1.

Treatment for varicose veins by ambulatory selective varicose vein ablation, under local anesthesia method

• Jang W

• KMID: 2561045
• DOI: http://doi.org/10.25056/JCM.2018.2.1.1

Abstract

Chronic venous disease of lower extremities is a common vascular problem. The method for ambulatory selective varicose vein ablation, under local anesthesia (ASVAL) without saphenous vein ablation, is based on a concept opposite to that of the traditionally accepted method. According to the traditional concept, the ascending evolution of a varicose disease starts from the peripheral veins, that is, involving the smallest and superficial veins with the most fragile walls would be dilated first. However, the theory of ascending evolution is not 100% valid for all venous diseases. For conducting a successful ASVAL, a vein specialist is recommended to deliberately reject the patients who manifest more advanced varicose disease. A number of patients with varicose veins have been classified as manifesting an earlier stage C2 disease, and they can be treated by performing extensive phlebectomies using ASVAL procedure. If advanced skin changes or ulceration (C4 to C6 disease) have already occurred resulting from the underlying venous disease, any attempt to use the ASVAL method will result in high rates of recurrence, since the saphenous vein and its valves might have already been damaged irreversibly. The criteria for obtaining best results from using ASVAL include: involvement of small saphenous vein, preferably less than 6 mm in diameter; younger patients, who may respond better; and nulliparous women.

Keyword

ASVAL; chronic venous disease; phlebectomy