Electrocautery for Endovenous Thermal Ablation of the Great Saphenous Vein : An Ex Vivo Feasibility Study
Abstract
Objective: To evaluate the feasibility, determine appropriate power and ablation duration, and assess the efficacy of using a standard surgical electrocautery device with a metallic guidewire for catheter-based endovenous ablation of the great saphenous vein (GSV) in an ex vivo model, based on macroscopic and microscopic examinations of thermal injury across all venous wall layers and perivenous tissues.
Methods: Twenty segments of human GSV were divided into four groups according to power output (50 and 60 watts) and ablation duration (5 and 10 seconds). Endovenous tissue injury was assessed by gross inspection and histological examination to determine the depth of thermal destruction.
Results: No macroscopic or microscopic damage to perivenous tissue was observed in the 50-watt groups, whereas evident tissue destruction was found in the 60-watt groups, with a 70% rate of microscopic injury. Statistically significant differences among groups, stratified by power and duration, were observed in terms of tissue injury depth (p = .018), adventitial layer destruction (p = .003), and perivenous tissue damage (p = .013). The 50-watt setting for 10 seconds achieved consistent full-thickness ablation of the GSV without affecting surrounding tissues.
Conclusion: Standard surgical electrocautery at 50 watts for 10 seconds effectively ablated all layers of the GSV in an ex vivo model without causing perivenous injury. These findings suggest that commonly available surgical electrocautery units may serve as a potential alternative for catheter-based treatment of varicose vein and warrant further clinical investigation to confirm these outcomes.
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