PMC6594284_01
Partially obstructing, isoechogenic mass with hyperechogenic components (arrows) at the saphenofemoral junction in a medially situated eccentric dilatation of the great saphenous vein distally from the terminal valve.
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fig1
This mass was only partially obstructing the GSF (Figure 1).
The tip of the laser fiber (white arrow) is stuck at the distal thrombotic mass (white-dashed line).
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fig2
The thrombotic mass was passed under echographic guidance by maneuvering the tip laterally to the thrombotic mass (Figure 2) without dislodging the thrombus (Figure 3) by gently steering the fiber, applying distal external manual pressure onto the laser fiber.
The tip of the laser fiber (arrow) is placed at the confluence between the great saphenous vein (white circle) and the common femoral vein (CFV).
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fig3
The thrombotic mass was passed under echographic guidance by maneuvering the tip laterally to the thrombotic mass (Figure 2) without dislodging the thrombus (Figure 3) by gently steering the fiber, applying distal external manual pressure onto the laser fiber.
Result 13 days after endovenous laser ablation of the great saphenous vein (GSV) with exclusion of the thrombotic mass. The GSV (longitudinal view) is occluded up to the confluence (white arrow) between the great saphenous vein and the common femoral vein (CFV).
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fig4
Duplex ultrasound visits on day 1 and day 13, at 6 weeks, and one year after the intervention showed a permanent occlusion of the treated GSV up to the confluence without evidence of any thrombus propagation into the deep vein system (Figure 4).