Document Detail

Proof-of-principle study of steam ablation as novel thermal therapy for saphenous varicose veins.
MedLine Citation:
PMID:  20801604     Owner:  NLM     Status:  MEDLINE    
INTRODUCTION: During the last decade, thermal ablation techniques such as endovenous laser ablation have been challenging the position of traditional surgery for the treatment of saphenous varicose veins. The newest method of thermal ablation is pulsated steam, which works by heating the vein with steam at 120°C. This study assessed the effectiveness of steam ablation of varicose veins in sheep and in humans.
METHODS: The safety of the procedure in sheep was assessed by cardiovascular monitoring during treatment. We used ultrasound imaging to examine occlusion of the veins. Changes in treated veins were examined microscopically. In a pilot study, 20 veins in 19 patients with insufficiency of the great or the small saphenous vein were treated with pulsated steam ablation. Anatomic success, patient satisfaction, and complications were investigated for 6 months after the procedure.
RESULTS: All veins in the sheep were occluded. No cardiovascular changes occurred during treatment. Histologic examination of treated veins showed typical changes of the vein wall, such as disappearance of the endothelial layer, fibrotic thrombosis, and major alterations in collagen fibers in the media. Steam ablation was effective in the 19 patients: 13 of 20 veins were completely closed, and 7 showed a very small segment of recanalization after 6 months of follow-up that did not seem to be clinically relevant. Nine patients had some ecchymoses at the puncture site, and one patient had a transient superficial phlebitis. A median maximal pain score of 1 (range, 0-10) was reported. No serious side effects, such as deep vein thrombosis, nerve injury, skin burns, or infections, were reported. Patients were very satisfied with the treatment, with a median satisfaction score of 9.25 (range, 0-10).
CONCLUSIONS: In this proof-of-principle study, pulsated steam ablation was an effective treatment for saphenous varicose veins.
Renate R van den Bos; Rene Milleret; Martino Neumann; Tamar Nijsten
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Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  Journal of vascular surgery     Volume:  53     ISSN:  1097-6809     ISO Abbreviation:  J. Vasc. Surg.     Publication Date:  2011 Jan 
Date Detail:
Created Date:  2010-12-27     Completed Date:  2011-01-31     Revised Date:  2012-10-03    
Medline Journal Info:
Nlm Unique ID:  8407742     Medline TA:  J Vasc Surg     Country:  United States    
Other Details:
Languages:  eng     Pagination:  181-6     Citation Subset:  IM    
Copyright Information:
Copyright © 2011 Society for Vascular Surgery. Published by Mosby, Inc. All rights reserved.
Department of Dermatology, Erasmus MC, Rotterdam, The Netherlands.
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MeSH Terms
Endovascular Procedures
Middle Aged
Saphenous Vein* / surgery,  ultrasonography
Sclerotherapy / methods*
Stockings, Compression
Ultrasonography, Interventional
Varicose Veins / pathology,  surgery*,  ultrasonography
Reg. No./Substance:
Comment In:
J Vasc Surg. 2011 May;53(5):1454-6   [PMID:  21575763 ]

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