Thermoablation using the hedgehog technique for complex recurrent venous reflux patterns

• Main Authors: Barrie A. Price, MD, MS, FRCS, FCPhleb, Charmaine C. Harrison, DMU, DCR, Judy M. Holdstock, DMU, DCR
• Format: Article
• Language: English
• Published: Elsevier 2016-12-01
• Series: Journal of Vascular Surgery Cases and Innovative Techniques
• Online Access: http://www.sciencedirect.com/science/article/pii/S2468428716300405

Neovascularization after vein stripping is well recognized as a contributory cause of varicose vein recurrence. Treatment is challenging because of segment tortuosity and fibrous web formation. Surgical re-exploration is practiced, but foam sclerotherapy is becoming preferred. We suggest an alternative method using thermoablation with a technique originally intended for treatment of perforator vein reflux. This modification has not been described in the context of recurrent neovascularization before. By ultrasound-directed insertion of multiple intravenous cannulas into convoluted neovascularized segments, recurrences in the groin, popliteal fossa, and truncal vein strip tracks can be successfully ablated by endovenous laser ablation.