Starting an endovascular vein program : tools, facilities and management of patients Jacques Bleyn...
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![Page 1: Starting an endovascular vein program : tools, facilities and management of patients Jacques Bleyn Antwerp Blood-vessel Center (ABC) Belgium.](https://reader038.fdocuments.in/reader038/viewer/2022103111/5517a0995503463e368b5ae0/html5/thumbnails/1.jpg)
Starting an endovascular vein program : tools, facilities and
management of patients
Jacques Bleyn
Antwerp Blood-vessel Center (ABC)
Belgium
![Page 2: Starting an endovascular vein program : tools, facilities and management of patients Jacques Bleyn Antwerp Blood-vessel Center (ABC) Belgium.](https://reader038.fdocuments.in/reader038/viewer/2022103111/5517a0995503463e368b5ae0/html5/thumbnails/2.jpg)
ABC principles
• Endovascular• Percutaneous• Local anaesthesia• Day clinic
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Is it necessary to do these treatments in a clinic or can they be done safely office-
based?
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Preop preparation
• No preop examinations• Mild anxiolytic drug• Shaving over the varicose veins• Antithrombotic stocking at the
controlateral limb• Marking with echography in standing
position by the surgeon that will perform the intervention
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![Page 6: Starting an endovascular vein program : tools, facilities and management of patients Jacques Bleyn Antwerp Blood-vessel Center (ABC) Belgium.](https://reader038.fdocuments.in/reader038/viewer/2022103111/5517a0995503463e368b5ae0/html5/thumbnails/6.jpg)
local anesthesia
• Under echo graphic control with isotonic bicarbonate solution with only 20 cc Xylocain 1%/500 cc.
• Femoral block with 30cc Lidocain 1% to make the administration of the tumescence painless
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Isotonic bicarbonate please
Courtesy of Dr. Denis Creton
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![Page 9: Starting an endovascular vein program : tools, facilities and management of patients Jacques Bleyn Antwerp Blood-vessel Center (ABC) Belgium.](https://reader038.fdocuments.in/reader038/viewer/2022103111/5517a0995503463e368b5ae0/html5/thumbnails/9.jpg)
Tumescent anesthesia under echo
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Endovenous treatment
• Puncture of the Saphenous Vein at knee level under echography or at ankle.
• Positioning of the catheter at the Sapheno-femoral junction.
• Administration of the tumescent anaesthesia and RF-treatment.
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Puncture under echography
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![Page 13: Starting an endovascular vein program : tools, facilities and management of patients Jacques Bleyn Antwerp Blood-vessel Center (ABC) Belgium.](https://reader038.fdocuments.in/reader038/viewer/2022103111/5517a0995503463e368b5ae0/html5/thumbnails/13.jpg)
Surgical complement
• Müller excision of varicous side branches in thigh and calf under local anaesthesia with the same bicarbonate solution
• Steristrips, compression bandage and immediate mobilisation.
• Discharge +/- 2 hours postop with elastic stocking for 1 week. 24 hrs work incapacity.
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conclusionTo start your endovenous programme,
you need:• An endovascular mind.• A quality Duplex scan and the necessary
skill to use it pre- and peroperatively, a sterile sleeve and sterile gel.
• Local anaesthesia skills.
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Conclusion 2
This is all easy to obtain and will make you hate classical surgical stripping.
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Thank you