Abstract
Chronic venous insufficiency is a common and treatable medical condition which has
a high morbidity if left untreated, progressing to lower extremity edema, skin changes
of lipodermatosclerosis, and venous ulceration. Treatment options have significantly
expanded over the last several decades, shifting away from the traditional surgical
approach to more minimally invasive procedures such as endoluminal venous laser ablation
or radiofrequency ablation. Even more recently, several techniques using nonthermal
methods to ablate varicose veins have been developed, which offer the advantage of
not requiring labor-intensive and painful tumescent anesthesia to protect the surrounding
tissues. These techniques include mechanochemical ablation, cyanoacrylate closure,
or polidocanol microfoam injection and can be offered to a wider range of patients
without the need for sedation while offering similar closure rates and improved postprocedure
symptom profile. Furthermore, certain patient characteristics which might preclude
or complicate the use of thermal ablation methods might not pose a problem with nonthermal
nontumescent methods.
Keywords
Thermal tumescent - nonthermal nontumescent - axial vein reflux - interventional radiology
