From the Guidelines
The reflux time that indicates Endovenous Ablation Therapy is typically greater than 0.5 seconds in the superficial and deep calf veins, and more than 1 second in the femoropopliteal veins, as measured by Doppler ultrasound 1.
Key Considerations
- Patients with saphenous vein reflux times exceeding these thresholds are considered candidates for Endovenous Ablation Therapy, which may involve the use of sclerosing agents such as sodium tetradecyl sulfate or polidocanol 1.
- Treatment durations typically range from 30 to 60 minutes, with follow-up assessments scheduled at 1-3 months post-procedure to evaluate treatment efficacy 1.
- The choice of treatment, including Endovenous Ablation Therapy, is based on symptoms, patient preferences, and other considerations such as cost, potential for complications, and availability of resources 1.
Treatment Options
- Endovenous thermal ablation (using a laser or radio waves) is used for larger vessels, including the greater saphenous vein 1.
- Endovenous sclerotherapy is another option, which involves the use of sclerosing agents such as hypertonic saline, sodium tetradecyl, or polidocanol 1.
- The efficacy and safety of Endovenous Ablation Therapy have been demonstrated in multiple studies, with occlusion rates ranging from 91% to 100% within 1-year post-treatment 1.
From the Research
Reflux Time Indicative of Endovenous Ablation Therapy
- The reflux time is a crucial factor in determining the effectiveness of Endovenous Ablation Therapy, with a reflux time of ≥0.5 seconds being a common indication for treatment 2.
- Studies have shown that endovenous ablation can significantly improve venous hemodynamics and relieve associated symptoms in patients with reflux times greater than 0.5 seconds 3, 4.
- The improvement in venous clinical severity scores (VCSS) and venous refilling time (VRT) after endovenous ablation is significant, with VCSS scores decreasing from 4.4 ± 1.3 to 1.7 ± 0.9 and VRT increasing from 20.3 ± 5.0 to 131.1 ± 4.0 3.
- Reflux in the below-knee great saphenous vein can be safely treated with endovenous ablation, with minimal complications and significant improvement in symptoms 5.
- However, persistent below-knee great saphenous vein reflux following endovenous laser ablation of above-knee great saphenous vein may be associated with residual symptoms and a greater need for sclerotherapy 6.