Therapeutic innovations in phlebology

Endovenous therapies are frequently used for treating saphenous veins, especially in western countries. Endovenous laser ablation and radiofrequency ablation can be performed using local tumescent anesthesia. They work by heating the vein wall. The obliteration rate of these techniques is very high, the side-effects are mostly restricted to postoperative pain and ecchymosis. Steam ablation is a new endovenous thermal technique which was introduced to minimize postoperative pain. Mechanochemical ablation and cyanoacrylate ablation are two new techniques that are tumescentless procedures. Evidence for these three techniques is still sparse.