Endovenous steam ablation of saphenous trunk and big tributaries:

When I see the potential advantages of SVS method?Michał Molski MD PhD

CRACOW 08.12.2016

Conflict of interest disclosureNothing to declare

Michał Molski MD PhD

• Endovenous thermal ablation techniqe• Allows treatment of GSV/SSV truncs• Allows treatment of tributaries• Allows treatment of perforating veins

ALL IN ONE PROCEDUREWithout additional techniques (miniphlebectomy or sclerotherapy)

BUTMay be combined with any of other phlebological technique

Steam Vein Sclerosis - Venosteam

SVS – procedure technique

Flexivein – 16G, 65 cm

SVS – procedure technique

Tribvein – 18G, 12cm

SVS – CASE #1

• Incompetence of LAASV LGSV Big varicosities• Trunc diameter 10mm

SVS – CASE #1

• Catheters placement• Flexivein – 16G, 65 cm applicator

1. LAASV

2. LGSV

3. Varicosities

SVS – CASE #1

1

SVS – CASE #1

2

SVS – CASE #2• Incompetence of RGSV Big varicosities• Trunc diameter 10mm• Catheters placement. Flexivein – 16G, 65 cm applicator

1. RGSV

2. Varicosities

SVS – CASE #2

3

S.J. Before 6 days after 100 days after

SVS - Results

S.J. Before 6 days after 35 days after

SVS - Results

730 C2-C6 patients treated 10.2013 – 10. 2016

x SVT - 15%x Skin hiperpigmentation – 10%x Minor skin burns – 10%x Paresthesia – 3%x Infection – 1%x Allergic reactions 1%x EHIT 0,5%x Symptomatic DVT 0%

x Recanalisationx Total – 3%x Partial 15%

SVS - Complications

SVS – tricks and tipsnavigation

• Shaping of catheter tip to cross single tortuosities

• Intermittent ablation of long trunks• Cooling an enty site during ablation

SVS – tricks and tipscatheter entry site burn prevention

Conclusions

SVS is an efficatious and safe ablative technique

SVS is very useful in treatment of coexistance of:• Big varicosities• Big diameter saphenous trunk • Reccurent varicosities• Incompetent perforators