Gerald Niedzwiecki

The development of catheter-based endovascular techniques for the treatment of venous insufficiency has ushered in a new era in the treatment of venous disease. These catheter-based techniques have allowed multiple different specialties ranging from dermatology, gynecology, family practitioners, wound care physicians, and interventional radiologists to enter into the full treatment spectrum of venous disease. Previously, as high ligation and stripping were the gold standard therapy for saphenous insufficiency only a small group of vascular surgeons, general surgeons, and cardiothoracic surgeons would treat venous insufficiency of the saphenous vein. A body of literature as outlined in previous chapters now supports the superiority of endovascular techniques such as radiofrequency closure and endovenous laser therapy over high ligation and stripping. Not only are these techniques less painful, offer a shorter recovery time, and avoid the risks of general anesthesia, but they also avoid the late development of neovascularization in the groin. Combining these techniques with ambulatory phlebectomy and sclerotherapy allow any practitioner interested in these often challenging patients to treat all degrees of superficial venous insufficiency.