4:02 PM Abstract No. 165 EVLA of lower extremity superficial venous reflux disease: relationship between long-term recanalization rates and energy density S.H. Ahn 1 , E.A. Prince 1 , N. Mahajan 1 , B. Van Zandt 1 , G. Soares 1 , G. Dubel 1 , D.S. Marshall 2 , S. Reddy 3 ; 1 Vascular and Interventional Radiology, Brown University/Rhode Island Hospital, Providence, RI; 2 Radiology, UCSF, SF, CA; 3 Alpert Medical School Of Brown University, Providence, RI Purpose: To determine if energy density (Joules/cm) effects long-term success of EVLA of lower extremity superficial venous reflux. Materials and Methods: IRB and HIPAA compliance were obtained. A retrospective review of EVLA treatments performed at a busy outpatient interventional radiology office was performed. Data collected included age, sex, vein segment treated, energy density (J/ cm), length of vein treated, ultrasound follow-up intervals, and recanalization. Vein segments treated were divided into o60 J/cm, 60-80 J/cm, and 480 J/cm. Comparison of recanalization rates among varying energy density groups were performed. Results: There were 2127 vein segments treated from July 2003 to March 2012. Average age of patients were 51.3 years (range 21-86 years) with 1458 women and 347 men treated. Average follow-up was 298.7 days (range 5-1983). Average energy density was 86 J/cm with recanalization rate of 3.24% (69 of 2127). The recanalization rates for o60 J/cm, 60-80 J/cm, and 4 80 J/cm were 5.57% (23 of 413), 4.77% (24 of 502), and 1.82% (22 of 1211) respectively. There is statistically significant lower recana- lization rate in the 4 80 J/cm group compared to o 60 J/cm group (p¼0.03). The lower recanalization rate in the 4 80 J/cm compared to 60-80 J/cm group almost reached statistical sig- nificance (p¼0.08). The lower recanalization rate in the 60-80 J/cm group compared to the o 60 J/cm group was not statistically significant (p¼0.731). Conclusion: This retrospective review of 2127 vein segments treated showed that EVLA performed with energy density 480 J/cm had the lowest long term recanalization rate. The study suggests that target energy density should be 480 J/cm to obtain highest long term success. 4:10 PM Abstract No. 166 Endovascular laser venous ablation for treatment of spermatic and ovarian venous insufficiency in male varicocele and female pelvic congestion syndrome A. Chamsuddin 1,2 , R. Achou 2 ; 1 CLIS, Atlanta, GA; 2 Radiology, St George Hospital, Beirut, Lebanon Purpose: To describe and evaluate a new approach for endo- vascular treatment of spermatic and ovarian venous insufficiency as a mean for minimally invasive therapy for male varicocele and pelvic congestion syndrome. Materials and Methods: Between February 2009 and July 2012, 11 patients with mean age of 18.45 years (age range: 11-31 years) underwent endovascular treatment of spermatic/ovarian venous insuffiency with endovascular ablation of the refluxing venous lumen using the 980 nm laser fiber system. The spermatic/ ovarian veins were accessed via left sided internal jugular vein puncture in all patients. In both female patients and three of the male patient, initial foam injection of the tortuous pelvic/testicular veins was performed followed by coil embolization of the immediate draining vein segment. The remaining trunk of the vein was ablated with a 980 endovascular laser fiber up to 2 cm from the junction of the vein with the left renal vein/IVC. The rest of the patients underwent foam injection followed immediately by laser abaltion of the venous trunk. Follow up venograms were performed at the termination of the procedure. Results: The procedure was successful in all 11 patients. Post procedure pain was the most common complaint described as severe flank/back pain. These symptoms were worse in the female patients and lasted for up to 6 days. In the male population, symptoms were milder and lasted 24-48 hours. There was complete resolution of pelvic congestion syndrome in the female patients within one month of the procedure. In the male population, there was progressive regression of the enlarged varicocele which completely resolved by an average period of 2.2 months (3 weeks-4 months). There was no evidence of ureteral, arterial or venous injury. Procedures lasted an average of 1 hour (30 minutes-2 hrs). Conclusion: Endovascular laser venous ablation, now a common technique for treatment of lower extremities venous insufficiency is a safe and efficient therapy for treatment of spermatic and ovarian venous insufficiency. Further evaluation on a larger scale is however needed. 4:18 PM Abstract No. 167 Balloon-assisted catheter-directed thrombolysis for acute lower extremity deep vein thrombosis C. Ni, Z. Li, Y. Jin, B. Fan, C. Yang; Interventional Radiology, First Affiliated Hospital of Soochow University, Suzhou, China Purpose: To investigate the efficacy and safety of balloon- assisted catheter-directed thrombolysis (CDT) for acute lower extremity deep vein thrombosis (DVT). Materials and Methods: From Sep 2008 to Feb 2011, 94 patients with acute DVT were admitted and treated by routine CDT (Group A,n¼50) in early stage or by balloon-assisted CDT (Group B, n¼44) in late stage.The circumference difference between limbs, score of venous patency, rate of venous patency were recorded for judging efficacy. The total dose of urokinase and retention time of catheter was compared between the two groups. The incidence of pulmonary embolism (PE) and bleeding were used to judge the safety. Results: The prior treatment circumference difference between limbs were 5.371.97 cm (thigh) and 4.141.57 cm (calf) in Group A and 5.412.22 cm (thigh) and 4.051.61 cm (calf) in Group B, without significant difference ( P¼0.910; P¼0.774). The post treatment correspondences were: 2.961.10, 1.930.84 cm in Group A and 1.781.40, 1.411.17 cm in Group B; with significant difference (Po0.0001; P¼0.012). The prior treatment score of venous patency was 9 (8, 10) in Group A and 8.3 (7, 10) in Group B without significant difference (P¼0.1292). The post treatment correspondence was 3.5 (2, 5) and 0 (0, 1) with significant difference (Po0.0001). The rate of venous patency was 55.0% (42.3%, 72.4%) in Group A and 100% (88.5%, 100%) in Group B, with significant difference (P o0.0001). The total dose of urokinase were 5.95 (5.53, 7.23) 106U in Group A and 4.10 JVIR ’ Scientific Session Tuesday ’ S79 TUESDAY: Scientific Sessions