Less Invasive Ultrasonography-Guided High Ligation of Great Saphenous Vein in Endovenous Laser Ablation

Abstract

ENDOVENOUS LASER ABLATION (EVLA) HAS TWO PITFALLS: endovenous heat-induced thrombosis (EHIT) and great saphenous vein (GSV) recanalization. To eliminate these complications, we developed ultrasonographyguided high ligation (UGHL) using a puncture-sized incision as an adjunct treatment to EVLA. UGHL combined with EVLA was used in 20 patients. The GSV was encircled with 2-0 silk thread at 2 cm distal to the saphenofemoral junction through two incisions of 2-3 mm by using a Deschamps aneurysm needle under ultrasonographic guidance. UGHL was technically feasible in all cases, and no case presented with complications. UGHL may be used in addition to EVLA.