AVF Summit: Ablation Choices and Combined Venous Disease
Thermal Versus Non-Thermal Ablation: Efficacy and Cost
Radiofrequency and laser show comparable closure and recurrence rates, non-thermal devices spare nerves below the knee, and cost analyses favor thermal ablation as first line since non-thermal options rarely show superior outcomes at higher procedure cost.
Treating the Anterior Accessory Saphenous Vein
This vein causes recurrent varicosities in up to twenty percent of patients after great saphenous ablation, yet insurers often deny coverage due to its accessory naming; panelists treat it concomitantly whenever it feeds bulging varicosities with the great saphenous.
Combined Reflux and Obstruction: Treat the Patient, Not the Image
Case discussions of young athletes with superficial reflux and incidental iliac vein compression stressed correlating findings with symptoms, generally addressing reflux first in mildly symptomatic patients and reserving stenting for severe, quality of life limiting obstruction.
Technical Pearls: Perforators, Tortuosity, and Device Nuances
Presenters ablate escape perforators functioning as the saphenofemoral junction, combine thermal ablation with foam for tortuous segments, stay centimeters from the junction to avoid glue extension, and tailor pullback speed and energy dosing to vein diameter.
