The 3S technique: another minimally invasive technique in the treatment of saphenous varicose veins.

摘要

I read with interest the article by Nijsten et al in the January 2009 issue of the Journal that describes three minimally invasive techniques in the treatment of saphenous varicose veins: foam sclerotherapy, endovenous laser therapy, and radio-frequency ablation. Another procedure-the 3S saphenectomy (the 3S technique)-should be added to theses techniques. The 3S technique associates the surgical sectioning and sclerotherapy of saphenous veins under local anesthesia. It has been developed in France mainly by Vin et al. Many angiophlebol-ogists learned this technique during the educational program of the European School of Phlebology in Paris. It is useful in the following instances: (1) when surgery is not recommended because of an advanced age and/or in case of a leg ulcer or other complication; (2) when surgery is refused for a personal reason; and (3) when the varicose veins are too large to be treated with classical sclerotherapy. In selected cases, the 3S technique gives good results and should be completed by sclerotherapy in the distal portion of the saphenous veins. Moreover, in a study conducted in Spain, this technique decreased the overall rate of recurrence when compared to classical surgery (stripping).