Steam Ablation Therapy
Endovenous steam ablation (EVSA) is a new method of thermal vein ablation that works by heating the veins with steam to a maximum temperature of 120 degrees centigrade. Steam is ejected into the treated vein from two areas at the tip of the catheter
The procedure is very similar to EVLA and can be performed with the patient under local tumescent anesthesia in an outpatient setting. The vein is punctured with an 18-gauge needle or cannula under ultrasound guidance. After puncturing the vein, the steam catheter (1.2 mm diameter) is passed through the hollow needle into the vein and the echo-dense tip of the catheter is then carefully positioned 3 cm from the junction, under ultrasound guidance. After activation, the catheter releases small “puffs” of steam and is pulled back in a stepwise fashion. After the procedure, patients are advised to wear thigh-length medical elastic compression stockings (pressure range 25-35 mm Hg) for 1 week and to mobilize immediately after the treatment. The main limitation of steam ablation is the lack of evidence; only three reports on steam ablation have been published to date.
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