Endovenous thermal ablation. Standardization of laser energy: literature review and personal experience

Endovenous laser treatment is a new, minimally invasive technique for ablation of the incompetent great and small saphenous vein and their tributaries. Although the satisfactory safety/efficacy results of this technique, literature is poor regarding standardization of the energy needed to ablate the incompetent vein in order to have success and durability of the procedure. The aim of this paper is a review of the literature to find out if authors with large experience on endovenous laser treatment achieved a standardization of the delivered energy at the incompetent vein wall and if new concepts proposed by the authors, like cold saline anesthesia, echogenic vein occlusion and regular distribution of laser energy to the vein wall, can improve the technique in order to have optimum results.