Endovenous ablation is contraindicated or relatively unsuitable when venous anatomy precludes catheter-based treatment, specifically: aneurysmal dilation of the GSV close to the saphenofemoral junction, subcutaneous location of truncal veins above the saphenous fascia and close to the skin, and significant tortuosity of the GSV or SSV. [1] In these scenarios, high ligation and stripping is recommended as the preferred alternative (grade 1 strong recommendation

Stratil, Jan M., Maike Voss, and Laura Arnold. “WICID Framework Version 1.0: Criteria and Considerations to Guide Evidence-Informed Decision-Making on Non-Pharmacological Interventions Targeting COVID-19.” BMJ Global Health 5, no. 11 (November 1, 2020): e003699. https://doi.org/10.1136/bmjgh-2020-003699.

Taddio, A., Chambers, C. T., Halperin, S. A., Ipp, M., Lockett, D., Rieder, M. J., & Shah, V. (2009). Inadequate pain management during routine childhood immunizations: The nerve of it. Clinical Therapeutics, 31, S152–S167. https://doi.org/10.1016/j.clinthera.2009.07.022

Ebrahimi, O. V., Hoffart, A., & Johnson, S. U. (2020). The mental health impact of non-pharmacological interventions aimed at impeding viral transmission during the COVID-19 pandemic in a general adult population and the factors associated with adherence to these mitigation strategies [Preprint]. PsyArXiv. https://doi.org/10.31234/osf.io/kjzsp