Cryostripping of the Long Saphenous Vein with a Percutaneously Guided Probe

Abstract

Although the technique of vein removal with a cryoprobe is both simple and well known, it has not yet been widely accepted. A modified probe now eliminates difficulties in its use. The original probe has a tip that can be cooled with NO2 or CO2 to -85 degrees C to permit stripping by freezing the vein to the probe from inside the vein. This tip has now been provided with an anatomic curvature and a flexible guide tip, making it easier to introduce the probe into the incision and guide it distally with percutaneous support. WE report on the use of this modified instrument to strip 325 long saphenous veins. The modified probe has permitted us to increase the percentage of complete stripping procedures without further distal incisions from 67% to 91%. The procedure was successful in 62% of veins that had already undergone previous sclerosing procedures. Incomplete removal or duplicated long saphenous veins were easily remedied by subsequent stripping starting proximally from a small, distal incision. Stripping of the long saphenous vein with this modified and easily guided cryoprobe is rapid, uncomplicated, highly effective, and leaves fewer scars.