Cyanoacrylate glue is used extensively now for the closure of refluxing saphenous trunks, occasional deep tributaries and some perforating veins. The advantage over endothermal methods of closure is that tumescence is not needed. However, tumescence will be required for the actual varicose veins if they are removed using phlebectomies in a local anaesthetic setting. It… Read More »
Combined modalities are gaining popularity for the treatment of varicose veins. The aim is to provide a more complete treatment at the primary procedure which may not be possible using a single technique. The commonest example is endothermal ablation with concurrent phlebectomies (varicose vein removal). In this set-up both the refluxing saphenous trunk is treated… Read More »
MOCA is an abbreviation for mechano-chemical ablation. It is the combination of a rotating metal filament used to denude the venous endothelium and put the vein into spasm. Concomitant instillation of liquid sclerosant ensures venous destruction. The application device is inserted percutaneously, under ultrasound control, into the vein awaiting ablation and advanced proximally. The saphenous… Read More »
The use of glue in the ablation of refluxing saphenous trunks is gaining popularity. The main advantage is that tumescence is not required. This is of benefit to the patient because the perivenous injection of fluid is uncomfortable and the procedure time is shortened. Bilateral treatments are facilitated. In common with all endovenous treatments, patient… Read More »
Perforating veins are those which connect the deep veins to the superficial veins. To achieve this they pass through the deep fascia of the calf. Although the sapheno-popliteal junction is a perforating vein, it is not discussed in this section. Anatomical dissections from leg amputations in patients free of venous disease reveal that the perforating… Read More »
Crossectomy is a procedure which ligates the great saphenous vein (GSV) at its termination into the femoral vein. Usually, all the draining tributaries are ligated similarly as they join the GSV termination. The procedure can be performed under local or general anaesthetic. It can be combined with stripping of the GSV or performed alone if… Read More »