ASVAL («Ambulatory Selective Varices Ablation under Local anaesthesia») or the Muller microphlebectomy is a simple and minimally invasive surgical technique that allows eliminating side blanches or small isolated varices (tributaries of saphenous veins trunks) through tiny incisions (2 or 3 mm long). This intervention is an outpatient procedure which is performed under local anaesthesia without cutaneous sutures (as a rule).
Reasons for performing Muller ASVAL
- For cosmetic effect in case of small isolated loci of varices and on condition of absence of abnormalities in great and small saphenous veins trunks
- As a supplement to radiofrequency ablation (RFA) and CHIVA method, to eliminate collateral branches of great and/or small saphenous veins trunks.
The Muller technique is represented in the picture
Along the vein (Picture 1), either perforation is made with 18G needle, or tiny incisions are performed with a №11 (A) blade scalpel at regular intervals (approximately every 3-5 cm). A varicose vein is hooked up, exposed, transected (B, C) and eliminated through them (D). The wounds are so small that they even do not need sutures. After the procedure, it is necessary to wear compression stockings for a while. This video demonstrates the Muller technique.
This method of treatment is practised by Professor Dmytro Riazanov, Doctor of Medicine, who is extensively experienced in treating patients with lower extremity varicose vein disease.
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