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. 2023 Oct 18;33(1):46-49.
doi: 10.1055/s-0043-1776145. eCollection 2024 Feb.

ASVAL with Phlebectomy/Sclerofoam Technique: Preliminary Results

Alberto Garavello  1 , Paola Fiamma  1 , Enrico Oliva  2
Affiliations

ASVAL with Phlebectomy/Sclerofoam Technique: Preliminary Results

Alberto Garavello et al. Int J Angiol. .

Abstract

The ambulatory selective varicose vein ablation under local anesthesia (ASVAL) method recommends preserving the great saphenous vein (GSV), unless there is a serious terminal valve insufficiency, and suggests phlebectomy of superficial varicose reservoir as a primary treatment. To increase patient comfort, foam safety and cosmetic results, we used ASVAL with a mixed phlebectomy/foam technique on local anesthesia. Thirty consecutive patients treated with ASVAL phlebectomy-sclerofoam technique were reviewed retrospectively between December 2022 and April 2023. All patients were evaluated by clinical examination and duplex ultrasound (DUS); the main selection criteria were a minimal GSV insufficiency (main GSV < or = to 1 cm). Muller phlebectomy of tributaries at entry point in the saphenous trunk was performed; after 1 week, patients were checked for foam sclerotherapy of residual trunk. Under visual control, 0.5% polidocanol foam (from 5 to 10 cc. "Tessari Technique") was injected in visible veins and elastic compression with pad was applied for 1 week. Compression with Class I elastic stockings was prescribed, and patients were reviewed after 1 month. Postoperative complications included thigh hematoma in two patients, three thrombosis of injected trunk, and hyperpigmentation in three patients. No GSV thrombosis at DUS was recorded. In 27 patients, a satisfying cosmetic result was achieved, and in 3 patients a new foam session was needed. Phlebectomy/foam ASVAL technique is a safe, low-traumatic technique with no need of US guidance, with less risk of foam migrating in GSV, simple and inexpensive, for patients with less advanced GSV insufficiency.

Keywords: ASVAL; Tessari technique; foam; muller; phlebectomy; sclerotherapy; varicose veins.

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Conflict of interest statement

Conflict of Interest None declared.

Figures

Fig. 1
Fig. 1
Phlebectomy of right great saphenous vein tributary (the upper on thigh) and sclerofoam; pre- and postoperative results at 2 weeks.
Fig. 2
Fig. 2
Phlebectomy of right great saphenous vein tributary (arrow, on medial side of the thigh) and sclerofoam; pre- and postoperative results at 1 month.
See this image and copyright information in PMC

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