Segmental point obliteration technique for nerve-sparing endovenous laser ablation of the below-knee great saphenous vein.

Endovenous thermal ablation of the below-knee great saphenous vein (GSV) risks saphenous nerve injury because the vein and nerve lie in close apposition. We propose the segmental point obliteration technique, which delivers intermittent point-by-point laser pulses (6 W, ≈1 mm) instead of continuous pullback, with an interval of 1 to 2 seconds between pulses. In 13 patients (19 limbs) followed for 1 month, no paresthesia occurred, and complete occlusion was achieved in all limbs. Segmental point obliteration technique appears feasible for nerve-sparing below-knee GSV ablation, although more comparative longer-term studies are needed to determine its efficacy and overall role in below-knee GSV treatment.