ASVAL with Phlebectomy/Sclerofoam Technique: Preliminary Results

Area of Science:

• Vascular Surgery
• Dermatology
• Minimally Invasive Procedures

Background:

• Ambulatory selective varicose vein ablation (ASVAL) typically preserves the great saphenous vein (GSV) unless severe insufficiency exists.
• Superficial varicose reservoir phlebectomy is a primary treatment option.

Purpose of the Study:

• To evaluate the safety, efficacy, and cosmetic outcomes of a mixed phlebectomy/foam ASVAL technique.
• To improve patient comfort and procedural outcomes for varicose vein treatment.

Main Methods:

• Retrospective review of 30 patients treated with ASVAL phlebectomy-sclerofoam between December 2022 and April 2023.
• Inclusion criteria: minimal GSV insufficiency (≤1 cm).
• Procedure involved Muller phlebectomy of tributaries followed by polidocanol foam sclerotherapy of the residual trunk after one week, with compression and follow-up.

Main Results:

• No GSV thrombosis observed on duplex ultrasound (DUS).
• Minor complications included hematoma (2 patients), injected trunk thrombosis (3 patients), and hyperpigmentation (3 patients).
• Satisfying cosmetic results achieved in 27 patients; 3 required an additional foam session.

Conclusions:

• The phlebectomy/foam ASVAL technique is safe, minimally traumatic, and cost-effective for treating less advanced GSV insufficiency.
• This method does not require ultrasound guidance and reduces the risk of foam migration into the GSV.
• Offers good cosmetic outcomes and patient comfort.