Treatment of the small saphenous vein and tributary veins with endolaser associated with ultrasound-guided foam in a patient with post-thrombotic syndrome: presenting the TEThA technique

J Vasc Bras. 2024 Nov 29:23:e20230142. doi: 10.1590/1677-5449.202301422. eCollection 2024.

Abstract
in English, Portuguese

Chronic venous disease of the lower limbs is a highly prevalent pathology and endovenous thermoablation is the technique of choice for treatment of insufficient saphenous veins. However, there is still controversy about the best management for varicose tributaries. This article reports a case of outpatient treatment of reflux of the small saphenous vein and tributary veins in a 52-year-old female patient with post-thrombotic syndrome complaining of pain and edema in the right lower limb. We performed the Transfixing Endovenous Thermal Ablation (TEThA) technique with thermoablation of the small saphenous vein and varicose veins combined with ultrasound-guided administration of 2% polidocanol foam. After 30 days, the control Doppler ultrasound showed occlusion of the short saphenous vein and absence of ultrasound signs of varicose veins and thrombosis. The combined endovenous and perivenous treatment of lower limb varicose veins proved to be safe, fast, and effective.

Resumo: A doença venosa crônica dos membros inferiores possui alta prevalência, com termoablação endovenosa como técnica de escolha para o tratamento de veias safenas insuficientes. Porém, ainda há controvérsia sobre a melhor conduta para as veias tributárias varicosas. Este artigo relata um caso de tratamento ambulatorial de refluxo de veia safena parva e de veias tributárias em paciente do sexo feminino, de 52 anos, com síndrome pós-trombótica e queixa de dor e edema em membro inferior direito. Realizamos a técnica transfixing endovenous thermal ablation (TEThA) com termoablação da veia safena parva e de veias varicosas, combinada com espuma ecoguiada de polidocanol a 2%. Após 30 dias, no eco-Doppler de controle, havia oclusão de veia safena parva e ausência de sinais ecográficos de varizes em face posterior de perna direita e de trombose. O tratamento combinado endovenoso e perivenoso das varizes dos membros inferiores tem se mostrado seguro, rápido e eficaz.

Keywords: chronic venous insufficiency; endovenous laser therapy; esthetics; saphenous vein; varicose veins.

Publication types

  • Case Reports