Treatment of the small saphenous vein and tributary veins with endolaser associated with ultrasound-guided foam in a patient with post-thrombotic syndrome: presenting the TEThA technique.

Chronic venous disease of the lower limbs is a highly prevalent pathology and endovenous thermoablation is the technique of choice for treatment of insufficient saphenous veins. However, there is still controversy about the best management for varicose tributaries. This article reports a case of outpatient treatment of reflux of the small saphenous vein and tributary veins in a 52-year-old female patient with post-thrombotic syndrome complaining of pain and edema in the right lower limb. We performed the Transfixing Endovenous Thermal Ablation (TEThA) technique with thermoablation of the small saphenous vein and varicose veins combined with ultrasound-guided administration of 2% polidocanol foam. After 30 days, the control Doppler ultrasound showed occlusion of the short saphenous vein and absence of ultrasound signs of varicose veins and thrombosis. The combined endovenous and perivenous treatment of lower limb varicose veins proved to be safe, fast, and effective.