Junction jump sign: a useful adjunct to the precise positioning of the catheter tip during endovenous thermal ablation

Duplex ultrasound imaging plays a key role in the increasingly popular, minimally invasive endothermal treatment of varicose veins. Accurate placement of the echodense tip of endovenous catheter distal to the site of junctional incompetence is by far the most critical step in the entire thermo-ablative procedure. This is achieved technically by precise sonographic visualization of the junction and placement of the working tip of catheter distal to the junction. We wish to report an additional observation; the 'junction jump sign' where the tip of the catheter is observed to recoil towards the transducer as it traverses past the junction from the deep to the superficial venous system. This sign can be used as a useful adjunct to position with confidence the working tip, especially in situations where precise identification of the catheter tip is difficult.