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Endoluminal treatment of varicose veins.

Introduction Chronic venous insufficiency treatment options have changed dramatically over the last 10 years. Rapid endorsement of minimally invasive techniques has led to a proliferation of vein centers and growth in the number of venous procedures. Traditional treatment of venous insufficiency with high ligation and stripping is a time-tested and successful procedure that has been used worldwide. The transition to minimally invasive techniques, however, has progressively changed the treatment for this disease. Patients who previously would have had surgery in the hospital operating room under general anesthesia now commonly have a clinic-based procedure with local anesthetics only. The techniques that have enabled this transition utilized ablation of the vein with endoluminal techniques rather than physical removal of the diseased veins. The various ablative techniques share a common mechanism — injury to the vessel wall with an energy source — that results in progressive fibrosis of the vessel and occl...