This is the technique of extirpating a saphenous vein using a metal probe which has been cooled with liquid nitrogen. Although this is still above a cryogenic temperature (-180 or -150 degrees C), it fulfils its purpose as a saphenous vein extractor. There are many advantages in using cold to ablate the saphenous vein rather than mechanical stripping or endothermal heating with laser, steam or radiofrequency.
SORIN OLARIU In Timisoara we perform cryostripping regularly as a modern method of stripping the saphenous vein or as an alternative to endothermal ablation. We introduced the method in 2013 and have performed over 300 operations with good results.
The probe is introduced through a small crossectomy incision at the sapheno-femoral or sapheno-popliteal junction. It is then advanced retrograde down the saphenous trunk until it reaches the point of the venous segment that is to be removed. The probe is then cooled with liquid nitrogen (approx -85 degrees C) which causes the vein to adhere to the probe. Finally, the probe is gently withdrawn together with the attached saphenous trunk.
Advantages of cryostripping include a reduction in bleeding because many of the tributaries come out with the probe and the remainder of the detached tributaries are sealed with the freezing process. Nerve injury is less because the trunk is removed from within. This is in contrast to stripping using external stripper heads and endothermal techniques which may both interfere with the saphenous nerves. Furthermore, the freezing process may reduce the incidence of neovascularisation through less tissue trauma and the cold temperature may provide temporary pain relief.
From the economical point of view this method is very affordable because the freezing probes can be resterilised and reused. Although patients require general or regional anaesthesia, cryostripping can be performed in an ambulatory setting with a rapid return to work and a fast recovery.
Cryoprobe withdrawal (cryostripping). Gentle traction removes the saphenous vein from the patient.
Appearance of the cryoprobe after the saphenous vein has been cryostripped. The frozen vein has adhered to the probe.