Consensus for the Treatment of Varicose Vein with Radiofrequency Ablation
- Authors
- 조진현; 김우식; 정인목; 박기혁; 이태승; 강진모
- Issue Date
- 2014
- Publisher
- 대한혈관외과학회
- Keywords
- Varicose veins; Radiofrequency; Ablation; Consensus
- Citation
- Vascular Specialist International, v.30, no.4, pp.105 - 112
- Journal Title
- Vascular Specialist International
- Volume
- 30
- Number
- 4
- Start Page
- 105
- End Page
- 112
- URI
- https://scholarworks.bwise.kr/gachon/handle/2020.sw.gachon/13320
- ISSN
- 2288-7970
- Abstract
- The objective of this paper is to introduce the schematic protocol of radiofrequency (RF) ablation for the treatment of varicose veins. Indication: anatomic or pathophysiologic indication includes venous diameter within 2-20 mm, reflux time ≥0.5 seconds and distance from the skin ≥5 mm or subfascial location. Access: it is recommended to access at or above the knee joint for great saphenous vein and above the mid-calf for small saphenous vein. Catheter placement: the catheter tip should be placed 2.0 cm inferior to the saphenofemoral or saphenopopliteal junction. Endovenous heat-induced thrombosis ≥class III should be treated with low-molecular weight heparin. Tumescent solution: the composition of solution can be variable (e.g., 2% lidocaine 20 mL+500 mL normal saline+bicarbonate 2.5 mL with/without epinephrine). Infiltration can be done from each direction. Ablation: two cycles’ ablation for the first proximal segment of saphenous vein and the segment with the incompetent perforators is recommended. The other segments should be ablated one time. During RF energy delivery, it is recommended to apply external compression. Concomitant procedure: It is recommended to do simultaneously ambulatory phlebectomy. For sclerotherapy, it is recommended to defer at least 2 weeks. Post-procedural management: post-procedural ambulation is encouraged to reduce the thrombotic complications. Compression stocking should be applied for at least 7 days. Minor daily activity is not limited, but strenuous activities should be avoided for 2 weeks. It is suggested to take showers after 24 hours and tub baths, swimming, or soaking in water after 2 weeks.
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