Focused Ultrasound Therapy
Focused ultrasound is a rapidly evolving, noninvasive, therapeutic technology with the potential to improve the quality of life and decrease the cost of care for patients with varicose veins. This novel technology focuses beams of ultrasound energy precisely and accurately on targets in the body without damaging surrounding normal tissue.
How it Works
Where the beams converge, the focused ultrasound produces precise ablation (thermal destruction) of the varicose vein. This enables varicose veins to be treated noninvasively.
Advantages
The primary options for treatment of varicose veins are surgery, sclerotherapy, intravenous laser therapy, or radio frequency closure techniques.
For certain patients, focused ultrasound could provide a noninvasive alternative to these techniques with less risk of neurologic problems, phlebitis, wound issues, or other complications. It also requires no intravenous catheters, surgery, or anesthesia and can be repeated as needed.
Clinical Trials
A clinical trial in New Jersey is testing the Sonovein system for treatment of greater saphenous vein disease.
Regulatory Approval and Reimbursement
Theraclion’s Echopulse has achieved the CE Mark in Europe for its SONOVEIN® system after successful clinical trials.
Focused ultrasound treatment for varicose veins is not yet approved by regulatory bodies in the US or covered by medical insurance companies.
Notable Papers
Obermayer A, Aubry JF, Barnat N. Extracorporeal Treatment with High Intensity Focused Ultrasound of an Incompetent Perforating Vein in a Patient with Active Venous Ulcers. EJVES Vasc Forum. 2020 Dec 5;50:1-5. doi: 10.1016/j.ejvsvf.2020.11.005. eCollection 2021.
Barnat N, Grisey A, Gerold B, Yon S, Anquez J, Aubry JF. Vein wall shrinkage induced by thermal coagulation with high-intensity-focused ultrasound: numerical modeling and in vivo experiments in sheep. Int J Hyperthermia. 2020;37(1):1238-1247. doi: 10.1080/02656736.2020.1834626.
Whiteley MS. High intensity focused ultrasound (HIFU) for the treatment of varicose veins and venous leg ulcers – a new non-invasive procedure and a potentially disruptive technology. Curr Med Res Opin. 2019 Dec 6:1-4. doi: 10.1080/03007995.2019.1699518.
Barnat N, Grisey A, Lecuelle B, Anquez J, Gerold B, Yon S, Aubry JF. Noninvasive vascular occlusion with HIFU for venous insufficiency treatment: preclinical feasibility experience in rabbits. Phys Med Biol. 2019 Jan 7;64(2):025003. doi: 10.1088/1361-6560/aaf58d.
Kim MS, Kim JY, Noh SC, Choi HH. Thermal characteristics of non-biological vessel phantoms for treatment of varicose veins using high-intensity focused ultrasound. PLoS One. 2017 Apr 6;12(4):e0174922. doi: 10.1371/journal.pone.0174922. eCollection 2017.
Petrishchev NN, Semenov DU, Tsibin AU, Yukina GU, Berkovich AE, Bursian AA, Belyankin AB, Senchik KU. Effekt of blood flow shutdown on the vein damage when exposed to HIFU. Patol Fiziol Eksp Ter. 2017 Apr-Jun;61(2):46-50. Russian.
Henderson PW, Lewis GK, Shaikh N, Sohn A, Weinstein AL, Olbricht WL, Spector JA. A portable high-intensity focused ultrasound device for noninvasive venous ablation. J Vasc Surg. 2010 Mar;51(3):707-11. doi: 10.1016/j.jvs.2009.10.049. Epub 2010 Jan 4.
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