Digital Metronomes and Metric Devices for Venous Ablation Procedures

Ultrasound-guided endovenous ablation procedures have revolutionized the care of patients with venous reflux disease for more than a decade. Precise application of energy forms and substances that occlude superficial truncal veins is pivotal for technical success. Exact spatial and temporal delivery of ablative vectors to the vein is operator dependent, readily measurable, and hinges on precise timing of pullback of the various catheters and fibers that effect vein ablation. Several physical and online electronic pullback timing aids, including metronomes and other metric devices, are available to ensure precise ablation, although operators are often left to discover them. Although these are not ultrasound devices per se, they are essential adjuncts for the effective delivery of a key ultrasound-guided intervention and are used in direct proximity to ultrasound. To the authors’ knowledge, there are no publications regarding this key ablation step, which is typically dependent on operator resourcefulness.