Abstract: The value and evaluation of different minimally invasive endovenous techniques for varicose veins of lower extremities        WU Jian-jin, QU Le-feng. Department of Vascular & Endovascular Surgery, Changzheng Hospital, Naval Medical University，Shanghai 200003，China
Corresponding author：QU Le-feng, E-mail:qulefeng@smmu.edu.cn
Abstract    Varicose veins of the lower extremities are the most common vascular diseases.With the advancement of technology and concepts，minimally invasive endovenous techniques have become the main method of treatment for the disease above stage C2.However，due to various types，multiple principles，different indications，and irregular clinical applications，sometimes endovenous techniques cannot achieve the expected results.Different minimally invasive endovenous techniques share their own characteristics.Endovenous laser ablation（EVLA）and radiofrequency ablation（RFA）have low complication rate and high mid- and long-term closure rate for the treatment of the main saphenous vein，which are recommended by the guidelines as the first choice. Sclerotherapy is safe，effective，simple，and advantageous in the treatment of venous branches，perforating branches and recurrent varicose. Mechanochemical endovenous ablation（MOCA）has not been widely used in China because the medium and long-term closure rate is lower than that of endovenous thermal closure. Cyanoacrylate glue embolization（CGE）is expected to become a new option in the future because it does not require swelling anesthesia，is simple to operate，and has a high mid- to long-term closure rate.In clinical application，it is necessary to combine the needs of patients and the actual conditions of each department，and make a reasonable surgical plan of whether single or combined treatments.

Key words: varicose veins, endovenous laser ablation, radiofrequency ablation, sclerotherapy, mechanochemical endovenous ablation, cyanoacrylate glue embolization

摘要： 下肢静脉曲张是最常见的血管外科疾病。随着技术和理念进步，微创腔内手术已成为C2期以上治疗的主要方法。但因术式多样、原理不同、适应证不一、临床开展不规范等原因，有时并未达到预期疗效。不同的微创腔内术式各具特点，腔内激光消融术（EVLA）与射频消融（RFA）治疗大隐静脉主干并发症发生率低、中远期闭合率高，获指南推荐首选；硬化剂注射术在静脉属支、穿通支和复发曲张治疗上安全、有效、简捷，具有优势；机械化学腔内消融术（MOCA）因中远期闭合率不及腔内热闭合，国内未得到广泛应用；氰基丙烯酸盐黏合剂栓塞术（CGE）无须肿胀麻醉、操作简单、中远期闭合率高，未来有望成为新选择。在临床应用中，需结合病人需求与各单位实际情况，合理选择单独或不同术式联合治疗。

关键词: 下肢静脉曲张, 腔内激光消融术, 射频消融术, 硬化剂注射术, 机械化学腔内消融术, 氰基丙烯酸盐黏合剂栓塞术