High intensity focused ultrasound (HIFU) for the treatment of varicose veins and venous leg ulcers – a new non-invasive procedure and a potentially disruptive technology

Whiteley, Mark S

doi:10.1080/03007995.2019.1699518

Cited by 15 publications

(7 citation statements)

References 14 publications

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“…Treatment options have expanded and improved radically over the last 20 years and the invasive standard techniques of the 20 th century are becoming of historical interest only. The methods for treating venous reflux and varicose veins and their complications effectively are now in place; it is technological improvements that will provide the key to the delivery of further advances 59 .…”

Section: Discussionmentioning

confidence: 99%

The Evolution of the Treatment of Varicose Veins in the 21st Century

Price¹

2023

Preprint

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A description of the changes in the management of superficial venous disease that have occurred in the first two decades of the 21st century are explored. A brief overview of traditional techniques prior to this evolution is also described. Special focus is placed upon the treatment of difficult recurrent venous disease. Newer innovations at the time of writing are mentioned and their possible applications for future development suggested.

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Section: Discussionmentioning

confidence: 99%

The Evolution of the Treatment of Varicose Veins in the 21st Century

Price¹

2023

Preprint

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“…Varicose veins are enlarged veins of the leg that can significantly influence the flow of blood to the heart, causing extremity weakness, heaviness, pain, and clotting. HIFU is an appealing non-invasive option to treat varicose veins, providing an outpatient procedure under local anesthetic [ 62 ]. The 3.0 MHz treatment head of the Sonovein system is equipped with a cooling and coupling kit and includes a linear ultrasound probe that is confocally mounted, as shown in Figure 10 [ 20 ].…”

Section: Ultrasound-guided Hifu Systemsmentioning

confidence: 99%

Review of Robot-Assisted HIFU Therapy

Gunderman

Montayre

Ranjan

et al. 2023

Sensors

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This paper provides an overview of current robot-assisted high-intensity focused ultrasound (HIFU) systems for image-guided therapies. HIFU is a minimally invasive technique that relies on the thermo-mechanical effects of focused ultrasound waves to perform clinical treatments, such as tumor ablation, mild hyperthermia adjuvant to radiation or chemotherapy, vein occlusion, and many others. HIFU is typically performed under ultrasound (USgHIFU) or magnetic resonance imaging guidance (MRgHIFU), which provide intra-operative monitoring of treatment outcomes. Robot-assisted HIFU probe manipulation provides precise HIFU focal control to avoid damage to surrounding sensitive anatomy, such as blood vessels, nerve bundles, or adjacent organs. These clinical and technical benefits have promoted the rapid adoption of robot-assisted HIFU in the past several decades. This paper aims to present the recent developments of robot-assisted HIFU by summarizing the key features and clinical applications of each system. The paper concludes with a comparison and discussion of future perspectives on robot-assisted HIFU.

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“…HIFU allows ultrasound energy to be focused from a curved transducer outside of the body and to be directed through the skin and subcutaneous fat, to ablate tissue at the focal point. 143 The first machine of its kind commercially available for treating varicose veins is called “Sonovein” and is made by Theraclion in France.…”

Section: Treatmentsmentioning

confidence: 99%

Current Best Practice in the Management of Varicose Veins

Whiteley¹

2022

CCID

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This article outlines the current best practice in the management of varicose veins. “Varicose veins” traditionally means bulging veins, usually seen on the legs, when standing. It is now a general term used to describe these bulging veins, and also underlying incompetent veins that reflux and cause the surface varicose veins. Importantly, “varicose veins” is often used for superficial venous reflux even in the absence of visible bulging veins. These can be simply called “hidden varicose veins”. Varicose veins usually deteriorate, progressing to discomfort, swollen ankles, skin damage, leg ulcers, superficial venous thrombosis and venous bleeds. Patients with varicose veins and symptoms or signs have a significant advantage in having treatment over conservative treatment with compression stockings or venotropic drugs. Small varicose veins or telangiectasia without symptoms or signs can be treated for cosmetic reasons. However, most have underlying venous reflux from saphenous, perforator or local “feeding veins” and so investigation with venous duplex should be mandatory before treatment. Best practice for investigating leg varicose veins is venous duplex ultrasound in the erect position, performed by a specialist trained in ultrasonography optimally not the doctor who performs the treatment. Pelvic vein reflux is best investigated with transvaginal duplex ultrasound (TVS), performed using the Holdstock-Harrison protocol. In men or women unable to have TVS, venography or cross-sectional imaging is needed. Best practice for treating truncal vein incompetence is endovenous thermal ablation. Increasing evidence suggests that significant incompetent perforating veins should be found and treated by thermal ablation using the transluminal occlusion of perforator (TRLOP) approach, and that incompetent pelvic veins refluxing into symptomatic varicose veins in the genital region or leg should be treated by coil embolisation. Bulging varicosities should be treated by phlebectomy at the time of truncal vein ablation. Monitoring and reporting outcomes is essential for doctors and patients; hence, participation in a venous registry should probably be mandatory.

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High intensity focused ultrasound (HIFU) for the treatment of varicose veins and venous leg ulcers – a new non-invasive procedure and a potentially disruptive technology

Cited by 15 publications

References 14 publications

The Evolution of the Treatment of Varicose Veins in the 21st Century

The Evolution of the Treatment of Varicose Veins in the 21st Century

Review of Robot-Assisted HIFU Therapy

Current Best Practice in the Management of Varicose Veins

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