Feasibility and Safety of Flush Endovenous Thermal Ablation of the Great Saphenous Vein with Consecutive Foam Sclerotherapy of Saphenofemoral Junction Tributaries: A Single-Center Experience

<b>Background:</b> Blood flow from the saphenofemoral junction(SFJ) tributaries may cause recurrence of varicose veins. Flush occlusion is defined as the total occlusion of the great saphenous vein(GSV) right to the saphenofemoral junction. The purpose of this study was to evaluate the efficacy and safety of flush endovenous thermal ablation with saphenofemoral junction tributary occlusion. <b>Method:</b> Between January 2019 and December 2022, 722 patients (total of 1273 limbs) were diagnosed with chronic vein insufficiency by one surgeon at a single center. <b>Result:</b> Of the 722 patients, 476 (65.9%) were female and 246 (34.1%) were male. Of the 1273 limbs, endovenous laser ablation(EVLA) was performed in 609 limbs and radiofrequency ablation(RFA) in 664 limbs. Of the 1273 limbs, the recurrence rate was 3.69% (<i>n</i> = 47), the development of endovenous heat-induced thromboembolism(EHIT) was 0.31% (<i>n</i> = 4), and neovascularization was 1.49% (<i>n</i> = 19). <b>Conclusions:</b> Flush endovenous thermal ablation was an effective method for decreasing recurrence without inducing endovenous heat-induced thromboembolism. Consecutive foam sclerotherapy for saphenofemoral junction tributaries may be feasible for reducing the recurrence of varicose veins.