This document discusses endovenous steam ablation (SVS) of saphenous veins and tributaries. SVS allows for treatment of the great saphenous vein, small saphenous vein, tributaries, and perforating veins in a single procedure without additional techniques. The document presents two case studies and results from 730 patients treated with SVS showing high efficacy and low complication rates like skin pigmentation, minor burns, and paresthesia. It provides tips for catheter navigation and burn prevention. The conclusion is that SVS is an effective and safe ablation technique useful for large varicosities, saphenous trunks, recurrent varicosities, and incompetent perforators.

1. 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

2. Conflict of interest disclosure
Nothing to declare
Michał Molski MD PhD

3. • Endovenous thermal ablation techniqe
• Allows treatment of GSV/SSV truncs
• Allows treatment of tributaries
• Allows treatment of perforating veins
ALL IN ONE PROCEDURE
Without additional techniques (miniphlebectomy or sclerotherapy)
BUT
May be combined with any of other phlebological technique
Steam Vein Sclerosis - Venosteam

4. SVS – procedure technique
Flexivein – 16G, 65 cm

5. SVS – procedure technique
Tribvein – 18G, 12cm

6. SVS – CASE #1
• Incompetence of LAASV  LGSV  Big varicosities
• Trunc diameter 10mm

7. SVS – CASE #1
• Catheters placement
• Flexivein – 16G, 65 cm applicator

8. SVS – CASE #1
1

9. SVS – CASE #1
2

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

11. SVS – CASE #2
3

12. S.J. Before 6 days after 100 days after
SVS - Results

13. S.J. Before 6 days after 35 days after
SVS - Results

14. 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 Recanalisation
x Total – 3%
x Partial 15%
SVS - Complications

15. SVS – tricks and tips
navigation
• Shaping of catheter tip to cross single tortuosities

16. • Intermittent ablation of long trunks
• Cooling an enty site during ablation
SVS – tricks and tips
catheter entry site burn prevention

17. 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