Non-invasive thermal treatment of great saphenous varicose veins using echotherapy: update on efficacy and safety data from a series of cases.

Non-invasive thermal treatment of great saphenous varicose veins using ultrasound therapy: update of efficacy and safety data based on a series of cases.

HIFU is a fast-growing technology and its use is expanding in many therapeutic areas, particularly in interventional phlebology with ultrasound therapy, a non-endovenous thermal procedure that does not require venipuncture or skin invasion. SONOVEIN® technology, marketed 4 years ago, has shown spectacular results on great saphenous veins and incontinent perforators, with a very encouraging efficacy and safety profile, at the cost of a relatively long procedure. In the present study, we investigated the efficacy, safety and tolerance profile of ultrasound therapy with the new generation SONOVEIN® (S, HD) on a series of native and refluxing great saphenous veins (n = 6), in 5 different patients. We have thus confirmed the very encouraging results already observed with the first generation of SONOVEIN®, with a 100% occlusion rate immediately post-procedural and at follow-up up to 12 months. The tolerance profile, which is better than that of conventional endovenous thermal procedures, still needs to be improved, however, since local anaesthesia by tumescence had to be used in almost a third of patients (n = 2), with an average VAS of 4.6 for all procedures. Finally, remarkably, we demonstrated considerable progress in terms of time saving, with a rate of 2.3 min/cm of vein treated with SONOVEIN® S/HD, compared with 8.6 min/cm with the initial version of SONOVEIN®, making its routine use in the practice conceivable. These positive results need to be confirmed on a larger scale, by multicentre or even comparative studies, and over the long term, with follow-up extending beyond 12 months. HIFU therefore seems to have confirmed its place as a reliable alternative to endovenous thermal techniques and sclerotherapy.