Endovenous laser and RF are the gold standard in venous ablation
STEAM ABLATION
Steam ablation is a thermal ablation method like EVLA and radiofrequency (RF) that destroys incompetent vessels by applying heat. It was first described in 2011 and used in relatively few patients. In steam ablation, a very thin catheter is placed into the vessel to be ablated under ultrasound guidance. When the device is switched on, steam is introduced into the vessel wall at a temperature of 120 degrees through the side openings of this catheter, thereby destroying the vessel surface by heat.
In steam ablation, as in EVLA and RF, it is necessary to apply tumescent anesthesia around the vessel. Tumescent anesthesia will protect the surrounding tissue, drain the blood inside the vessel increasing the effectiveness of the procedure and prevent the patient from feeling pain. It is very important that steam ablation is performed under absolute ultrasound guidance like other methods. Inadequate or incorrect use of ultrasound can lead to serious complications in steam ablation as in other ablation procedures.
In steam ablation, the catheter inserted into the vein is very thin, so it can be used in curved vessels, even in the treatment of large varices. Furthermore, since the substance used is natural water vapor, there are no drug-related side effects. However, it is a novel technique and has been used in a relatively small number of patients. Therefore, it is not yet known whether it is equally effective and safe as proven methods such as laser and radiofrequency
It is very important that steam ablation be performed under absolute ultrasound guidance like other ablation methods.