One-year results of treatment of incompetent truncal veins and incompetent perforators using 8 and 4 second pulses of High Intensity Focused Ultrasound (HIFU)

Introduction: High Intensity Focused Ultrasound (HIFU) is a new extra-corporeal, non-invasive thermoablative technique to treat superficial venous incompetence in leg veins, which left untreated can cause symptomatic varicose veins and venous leg ulcers. To date, there is limited data surrounding the treatment outcomes of HIFU. This study aims to show the 1-year results of using HIFU, using the first CE marked HIFU machine for the treatment of varicose veins (Theraclion, Paris, France).

Method: Patients were treated with the HIFU machine with pulses of either 4 or 8 seconds. This study includes 51 patients, and 79 legs, with 43 truncal veins and 146 incompetent perforator veins. Patients were invited back for scans 1-2 weeks, 6-8 weeks, 6 months and 1 year after their treatment to identify the technical success rate of the HIFU treatment. No patients underwent phlebectomy, either at the time of HIFU treatment nor subsequently. Those patients with residual varicosities were treated with foam sclerotherapy as an adjunctive treatment.

Results: Twenty-four patients who had truncal veins treated with HIFU returned at 1 year. Successful ablation of the target vein was found in 79.1%. The 1-year results for the treatment of incompetent perforator veins with HIFU was 84.5%, out of 71 scanned 1 year after treatment. The overall percentage success decreased slightly between 1-2 weeks post-treatment and 1-year post-treatment.

Conclusion: The results produced by HIFU are similar to those of early EVTA. Some patients had adjunct ultrasound guided foam sclerotherapy to residual varicosities. The percentage success is expected to increase with experience and improved technology provided by the later generation machines.

Whiteley, M. S., Kiely, M. J., Croucher, A. A., Taylor, L., Hughes, B. E., Josserand, E., & Abu-Bakr, O. (2022, October 24). One-year results of treatment of incompetent truncal veins and incompetent perforators using 8 and 4 second pulses of High Intensity Focused Ultrasound (HIFU). https://doi.org/10.31219/osf.io/fzc5k