title: Consensus for the Treatment of Varicose Vein with Radiofrequency Ablation.
abstract: The objective of this paper is to introduce the schematic protocol of radiofrequency (RF) ablation for the treatment of varicose veins.
  
  
  METHODS
  anatomic or pathophysiologic indication includes venous diameter within 2-20 mm, reflux time ≥0.5 seconds and distance from the skin ≥5 mm or subfascial location. Access: it is recommended to access at or above the knee joint for great saphenous vein and above the mid-calf for small saphenous vein. Catheter placement: the catheter tip should be placed 2.0 cm inferior to the saphenofemoral or saphenopopliteal junction. Endovenous heat-induced thrombosis ≥class III should be treated with low-molecular weight heparin. Tumescent solution: the composition of solution can be variable (e.g., 2% lidocaine 20 mL+500 mL normal saline+bicarbonate 2.5 mL with/without epinephrine). Infiltration can be done from each direction. Ablation: two cycles' ablation for the first proximal segment of saphenous vein and the segment with the incompetent perforators is recommended. The other segments should be ablated one time. During RF energy delivery, it is recommended to apply external compression. Concomitant procedure: It is recommended to do simultaneously ambulatory phlebectomy. For sclerotherapy, it is recommended to defer at least 2 weeks. Post-procedural management: post-procedural ambulation is encouraged to reduce the thrombotic complications. Compression stocking should be applied for at least 7 days. Minor daily activity is not limited, but strenuous activities should be avoided for 2 weeks. It is suggested to take showers after 24 hours and tub baths, swimming, or soaking in water after 2 weeks.
authors.affiliation: Department of Surgery, Kyung Hee University Hospital at Gangdong, Seoul.
authors.forename: Jin Hyun
authors.initials: JH
authors.lastname: Joh
authors.affiliation: Department of Cardiothoracic Surgery, National Medical Center, Seoul.
authors.forename: Woo-Shik
authors.initials: WS
authors.lastname: Kim
authors.affiliation: Department of Surgery, SVU-SMG Boramae Medical Center, Seoul.
authors.forename: In Mok
authors.initials: IM
authors.lastname: Jung
authors.affiliation: Department of Surgery, Daegu Catholic University Medical Center, Daegu.
authors.forename: Ki-Hyuk
authors.initials: KH
authors.lastname: Park
authors.affiliation: Department of Surgery, Seoul National University Bundang Hospital, Seongnam.
authors.forename: Taeseung
authors.initials: T
authors.lastname: Lee
authors.affiliation: Department of Vascular Surgery, Gachon University Gil Medical Center, Incheon, Korea.
authors.forename: Jin Mo
authors.initials: JM
authors.lastname: Kang
keywords: Ablation; Consensus; Radiofrequency; Varicose veins