Non-surgical treatment of varicose veins using HIFU (high-intensity focused ultrasound)
The treatment of varicose veins and venous insufficiency is now benefiting from technological advances, particularly high-intensity focused ultrasound ( HIFU ), which in some cases allows for treatment without surgery or anesthesia. Available studies show ablation efficacy comparable to, or even superior to, conventional endovenous thermal techniques such as laser or radiofrequency ablation, with an excellent tolerability profile. Although this innovative technique is not covered by national health insurance, its overall cost often remains lower due to the absence of hospitalization and operating room procedures; a quote is systematically provided before each procedure. Clinically, HIFU is of major interest for frail patients, particularly those with significant trophic skin disorders, allowing treatment for patients who are not usually candidates for surgery or thermal techniques.
Operating principle of high-intensity focused ultrasound (HIFU)
How does it work ?
HIFU treatment of varicose veins involves closing a pathological vein remotely, without puncture or catheter, by focusing high-intensity ultrasound through the skin onto a precise segment of the vein.
Physical principle and effect on the vein
- A transducer sends focused ultrasound waves that converge at an intravenous focal point, like an “acoustic magnifying glass”, generating locally a rapid thermal rise (≈ 80–85 °C) or, depending on the system, cavitation phenomena.
- This energy damages the vein wall (thermal necrosis or mechanical lesions), leading to retraction, obliteration and then fibrosis of the vein, which is then reabsorbed by the body.
Practical details
- The treatment is guided in real time by ultrasound integrated into the treatment head, allowing precise targeting of the vein and protection of neighboring structures (skin cooling, depth adjustment).
- Energy is delivered by successive small impacts (on the order of a grain of rice) along the venous trunk, in a completely transcutaneous manner, without general anesthesia or incision.
Clinical interest
- Non-invasive technique, without scarring, without intravenous equipment, allowing a rapid return to activities and potentially suitable for tortuous veins or veins difficult to access for endovenous techniques.
• Available studies suggest ablation efficacy comparable to conventional endovenous thermal methods, with a favorable tolerance profile, while remaining expensive today and still in the diffusion/evaluation phase.
Clinical interest
- Non-invasive technique, without scarring, without intravenous equipment, allowing a rapid return to activities and potentially suitable for tortuous veins or veins difficult to access for endovenous techniques.
- Available studies suggest ablation efficacy comparable to conventional endovenous thermal methods, with a favorable tolerance profile, while remaining expensive today and still in the diffusion/evaluation phase.
What are the advantages of treating varicose veins with HIFU?
HIFU echotherapy offers above all a completely non-invasive nature, with fewer organizational constraints and a faster recovery than excision surgery.
Benefits for the patient
- No incision, therefore no scar, no stripping or staples, and a very low risk of skin infection.
- No venipuncture or probe passage, which limits hematomas, post-operative pain and peripheral nerve damage sometimes observed after stripping.
- Very light anesthesia or simple local analgesia, without heavy loco-regional anesthesia or general anesthesia in the vast majority of cases.
- Almost immediate resumption of walking and daily activities, without prolonged rest or structured convalescence as after extensive surgical phlebectomy.[6][3][5]
Specific clinical interest
- It is possible to treat segments that are difficult to access surgically (deep arch areas, very tortuous veins) because the firing is extracorporeal and guided in real time by ultrasound.
- This technology is of interest to patients at risk of bleeding, with impaired wound healing, or with a fear of surgery, offering an effective thermal alternative without skin penetration.
What is the price of a HIFU procedure for varicose veins without anesthesia?
Sources and references
[1] Echotherapy – Treatment with therapeutic ultrasound https://echotherapie.com/fr/
[2] Echotherapy (Sonovein) https://www.lem-w.com/section-medicale/echotherapie-sonovein/
[3] Varicose veins – Theraclion https://www.theraclion.fr/varices/
[4] High-intensity-focused ultrasound treatment for the chronic venous … https://pmc.ncbi.nlm.nih.gov/articles/PMC12018035/
[5] Echotherapy for varicose veins in the legs – Echotherapy https://echotherapie.com/fr/lechotherapie-des-varices-des-jambes/
[6] How to get rid of varicose veins? – Echotherapy https://echotherapie.com/fr/comment-se-debarrasser-des-varices/
[7] Are lasers and surgery a thing of the past? New weapons against… https://www.medtechfrance.fr/vie-de-la-profession/actualites/fini-le-laser-et-la-chirurgie-les-nouvelles-armes-contre-les-varices/
[8] SONOVEIN® – Medical device for the treatment of varicose veins https://www.theraclion.fr/products/sonovein-2/
[9] Echotherapy for varicose veins with SONOVEIN® HD https://www.youtube.com/watch?v=uQ97JAu5tGY
[10] Non-invasive treatment of varicose veins of the great saphenous vein … https://www.phlebo-online.org/article/traitement-thermique-non-invasif-des-varices-grandes-saphenees-par-echotherapie/
[11] Theraclion – Focused ultrasound medical device https://www.theraclion.fr
[12] High-intensity focused ultrasound · Dr. Olivier Creton https://docteur-creton.fr/la-chirurgie-moderne-des-varices/ultrasons-focalises-de-haute-intensite/
[13] Which procedures are best for treating varicose veins? … https://www.cochrane.org/fr/evidence/CD005624_which-procedures-are-best-treating-varicose-veins-leg
[14] Preliminary results of a study on the effectiveness of … https://www.academie-chirurgie.fr/admin/api/media/media?force_download=1&media_id=4981
[15] Argenteuil Hospital, the first public hospital to treat varicose veins without incisions – Argenteuil Hospital Center https://www.ch-argenteuil.fr/lhopital-dargenteuil-1er-hopital-public-a-traiter-les-varices-sans-incisions/