To present the use of retrograde mechanico-chemical endovenous ablation for ablating the remaining below-knee great saphenous vein in patients with venous stasis ulcers persisting after above-knee great saphenous vein ablation.

This small study includes six patients with persistent C₆E_pA_sP_r ulcers following above-knee great saphenous vein ablation with no incompetent perforators. They were treated using retrograde mechanico-chemical endovenous ablation approach followed by Unna therapy, followed up on post op days 3 and 30 with ultrasound, and subsequent weekly visits until the wound healed.

Six patients (four men and two women), have average ulcer size of 4.1 cm². There was no nerve injury or other complications after mechanico-chemical endovenous ablation. These patients had an average of 28 ± 11 days healing time, compared with a mean of five months in traditional method.

Mechanico-chemical endovenous ablation can be safe and effective in the treatment of patients with below-knee great saphenous vein insufficiency with venous ulcers.