At Inovia Vein Specialty Centers, we’re proud to share that our founder and medical director, Dr. Edward M. Boyle, was recently featured in the March 2025 issue of Endovascular Today. His article discusses important updates in the understanding and treatment of anterior saphenous vein (ASV) reflux, following a groundbreaking four-part series he co-authored in 2024, published in the Journal of Vascular Surgery: Venous and Lymphatic Disorders and Phlebology. This work was endorsed by leading vascular organizations including AVLS, AVF, and UIP.
Clarifying Terminology: From “Accessory” to “Anterior” Saphenous Vein
The term “anterior accessory saphenous vein” confused specialists, implying it was a minor tributary. Dr. Boyle and colleagues showed it’s a truncal vein, like the GSV or SSV, leading to the simplified “anterior saphenous vein” (ASV) label. This shift, backed by evidence, aims to improve treatment clarity and insurance coverage.
Impact on Vein Treatment
Recognizing ASV as a truncal vein supports using ablation methods (e.g., radiofrequency, cyanoacrylate) over less effective options like foam sclerotherapy. Dr. Boyle notes ASV reflux in 20% of initial venous reflux cases and as a common recurrence causes post-GSV treatment, aiding precise care plans.
Practical Tips
Dr. Boyle shares a useful diagnostic tip known as the “alignment sign.” On ultrasound, the ASV aligns with the femoral vessels, while the medial GSV does not. This key distinction helps avoid misdiagnosis and ensures accurate treatment planning.
Patient-Centered Approach to Care
Dr. Boyle emphasizes that treating veins should always be guided by patient symptoms, not just ultrasound results. Treatment decisions are best made by combining clinical history, physical examination, and imaging findings. For instance, if a small ASV is present but a large GSV is a driving symptom, the focus should be on the GSV. In more advanced cases, such as those involving venous ulcers, ASV ablation may be prioritized to promote healing. This individualized approach ensures that care aligns with each patient’s unique needs and goals.
Addressing Insurance Challenges
Insurance often lags with restrictive ASV coverage policies. Dr. Boyle’s work seeks to align payer rules with clinical needs, reducing delays and costs.
Learn More
To read Dr. Boyle’s feature in Endovascular Today, click here
For expert evaluation and personalized vein care, contact Inovia Vein Specialty Centers today.
Edward M. Boyle, MD
Founder and Director
Inovia Vein Specialty Centers — Serving patients in Tigard, NW Portland, Tanasbourne, Happy Valley, Bend (Oregon), and Vancouver (Washington)