Ambulatory Selective Varices Ablation Under Local Anaesthesia (ASVAL)

Abstract

The notion of traditional surgical treatment for varicose veins combining crossectomy and stripping as the “gold standard” seems to have had its days. Several important steps forwards have revolutionized varicose vein treatment with the emergence of new techniques since the beginning of the twenty-first century that have called the utility of crossectomy into question. Therefore, the way for another physiopathological theory of varicose veins was opened that questions whether the saphenous vein has initial responsibility for the development of the venous disease. Consequently, it has seemed logical to envisage an approach sparing the saphenous vein with a thorough treatment of the venous reservoir by the mean of micro-phlebectomy called the ASVAL method (ambulatory selective varices ablation under local anaesthesia). The results of this saphenous-sparing strategy have been reported as equivalent to the results of techniques that involve an ablation of the saphenous vein, more aggressive for the venous physiology, if the patients are properly selected.