HIFU Varices
Non-Surgical Treatment of Varicose Veins
The treatment of varicose veins and venous insufficiency is evolving and now benefits from high-intensity focused ultrasound (HIFU) technology. In certain specific cases, it is possible to avoid surgery altogether and perform the treatment without anesthesia.
How does it work?
HIFU treatment of varicose veins involves closing a diseased vein remotely, without puncture or catheter, by focusing high-intensity ultrasound waves through the skin onto a precise segment of the vein.
Physical Principle and Effect on the Vein
• A transducer emits focused ultrasound waves that converge at a focal point within the vein, like an "acoustic magnifying glass," generating a rapid local temperature increase (≈ 80–85 °C) or, depending on the system, cavitation.
• This energy damages the vein wall (thermal necrosis or mechanical lesions), leading to retraction, obliteration, and then fibrosis of the vein, which is subsequently reabsorbed by the body.
Practical Details
• The treatment is guided in real time by ultrasound integrated into the treatment head, allowing for precise targeting of the vein and protection of surrounding structures (skin cooling, depth adjustment).
• Energy is delivered through successive small impacts (on the order of a grain of rice) along the vein trunk, completely transcutaneously, without general anesthesia or incision.
Clinical Benefits
• This non-invasive technique leaves no scars and requires no intravenous equipment, allowing for a rapid return to normal activities and potentially suitable for tortuous veins or veins difficult to access with endovenous techniques.
• Available studies suggest ablation efficacy comparable to conventional endovenous thermal methods, with a favorable safety profile, although it remains expensive and is still in the dissemination/evaluation phase.
What are the advantages of HIFU treatment for varicose veins?
HIFU ultrasound therapy offers the significant advantage of being completely non-invasive, with fewer organizational constraints and a faster recovery than surgical excision.
Benefits for the patient:
- No incision, therefore no scar, no stripping or staples, and a very low risk of skin infection.
- No venipuncture or catheterization, which limits hematomas, postoperative pain, and peripheral nerve damage sometimes observed after stripping.
- Very light anesthesia or simple local analgesia, without heavy regional or general anesthesia in the vast majority of cases.
- Almost immediate resumption of walking and daily activities, without prolonged downtime or structured convalescence as after extensive surgical phlebectomy.
Specific Clinical Benefits
- The ability to treat segments that are difficult to access surgically (deep sarcovascular areas, highly tortuous veins) because the treatment is delivered extracorporeally and guided in real time by ultrasound.
- This technology is particularly beneficial for patients at risk of bleeding, with impaired wound healing, or who have 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?
This technique is not currently covered by French health insurance, but the surgeon can provide you with a preliminary quote that you can submit to your supplemental health insurance provider for reimbursement.
What are the advantages of HIFU ultrasound compared to surgery?
HIFU ultrasound therapy retains the benefits of thermal ablation while eliminating the need for skin penetration, thus improving comfort and recovery compared to surgical excision.
Advantages for the patient
- 100% non-invasive: no incision, no stripping, no visible scar, and a very low risk of skin infection.
- Minimal anesthesia (most often local or simple analgesia), without the general or heavy regional anesthesia required in traditional surgery.
- Post-procedure pain is generally minimal, with less hematoma and nerve traction than after vein stripping or extensive phlebectomies.
- Immediate resumption of daily activities, without significant convalescence or prolonged time off work for the majority of patients.
Organizational and logistical advantages
- The procedure is performed in a non-surgical environment (technical office/treatment room), without an operating room, a full sterile field, or a recovery room.
- The procedure is performed by a single operator, without invasive consumables (guide wires, catheters, puncture kits), which reduces logistics compared to surgery.
Specific clinical benefits
- Continuous ultrasound-guided remote treatment allows targeting of segments close to the sacroiliac joint, deep or tortuous, which are sometimes difficult to access surgically.
- An attractive option for patients at high surgical risk, with impaired wound healing, or who refuse surgery, offering an effective thermal alternative without skin penetration.
Sources
[1] Échothérapie - Le traitement par ultrasons thérapeutiques https://echotherapie.com/fr/
[2] Theraclion - Dispositif médical d'ultrasons focalisés https://www.theraclion.fr
[3] SONOVEIN® - Dispositif médical de traitement des varices https://www.theraclion.fr/products/sonovein-2/
[4] Traitement des varices | Soins non invasifs avec Sonovein® https://www.sonovein.com/fr
[5] L'Echothérapie (Sonovein) https://www.lem-w.com/section-medicale/echotherapie-sonovein/
[6] Un dispositif médical non-invasif pour traiter les varices https://www.lajauneetlarouge.com/sonovein-un-dispositif-medical-non-invasif-pour-traiter-les-varices/
[7] Traitement non invasif des varices de la grande saphène par ... https://www.phlebo-online.org/article/traitement-thermique-non-invasif-des-varices-grandes-saphenes-par-echotherapie/
[8] Fini le laser et la chirurgie ? Les nouvelles armes contre les varices https://www.medtechfrance.fr/vie-de-la-profession/actualites/fini-le-laser-et-la-chirurgie-les-nouvelles-armes-contre-les-varices/
[9] High-intensity-focused ultrasound treatment for the chronic venous ... https://pmc.ncbi.nlm.nih.gov/articles/PMC12018035/
[10] chirurgie moderne varices - Docteur CRETON https://docteur-creton.fr/la-chirurgie-moderne-des-varices/
[11] Varices Chirurgie : Stripping vs Laser - Guide 2025 - GuideChirurgie.fr https://www.guidechirurgie.fr/varices-chirurgie-stripping-laser/
[12] VeinSound développe un nouveau traitement des varices ... https://www.medicalps.eu/2019/06/24/veinsound-develops-a-new-varicose-vein-treatment-using-ultrasounds/
[13] Le stripping des varices - cette méthode a-t-elle encore ... https://medizinonline.com/fr/le-stripping-des-varices-cette-methode-a-t-elle-encore-une-raison-detre/
[14] ÉVALUER https://www.has-sante.fr/upload/docs/application/pdf/2023-06/rapport_occlusion_pvs_rf_vd.pdf
[15] La chirurgie conventionnelle ou stripping des veines https://www.sf-phlebologie.org/patients/la-chirurgie-conventionnelle-ou-stripping-des-veines/
[16] Résultats préliminaires d'une étude sur l'efficacité de l' ... https://www.academie-chirurgie.fr/admin/api/media/media?force_download=1&media_id=4981