Reflux testing and imaging for endovenous ablation.

Endovenous ablation is a newer therapy for treating superficial veins in patients with chronic venous disease. The saphenous veins and their accessory veins can be treated. Radiofrequency and laser energy are used to ablate the veins. Accurate ultrasound mapping is needed to plan and perform these procedures. The length and the number of the veins treated are determined. The diameter of the vein, its distance from the skin, and segments with tortuosity, thrombosis, and anatomic variations are documented. During the procedure the access in the vein, and the introduction of the wire, sheath, catheter, and tumescent anesthesia are done under ultrasound guidance. The success of the procedures and the complications are monitored. In most studies, the failure rate is 10% or less at 2 years, and the prevalence of deep vein thrombosis is less than 3%. Currently, endovenous ablation has become the method of choice for treating superficial veins and it has almost replaced the traditional ligation and stripping.