A new promise in conservative surgery

A new protagonist appears in the phlebology scene: HIFU (High Intensity Focused Ultrasound). It is a new non-invasive thermo-ablative method to treat superficial venous reflux: an ultrasound imaging guides a focused ultrasound energy. The technology was started since 2019 (A Obermayer conceived it and M Whitely applied it widely in phlebology), but it slowed down by Covid diffusion. Nowadays, it is better established, Paolo Casoni being probably one of the most universally recognized experts in the field. The interview aims to highlight some aspect of the HIFU experience, touching some non-cleared or even debatable details. A recent article (Casoni P, et al. Phlebology 2024) stimulated a series of clinical and anecdotal questions that we asked Dr Paolo CASONI, protagonist of a therapeutic experience that allows a true "no touch" treatment on varicose veins, the maximum desire of doctors and patients. In addition, in contrast with current thinking, a conservative strategy is proposed, based on a pathophysiological conception, which is however questionable and still undemonstrated.