The Early Results of Endovenous Radiofrequency Ablation Combined with Flush High Ligation for Patients with Varicose Veins

ABSTRACT

PURPOSE: Radiofrequency ablation of the great saphenous vein has proven efficacy with an excellent side effect profile, but it has the disadvantage of a lengthy pullback procedure. A new generation catheter (ClosureFast) was recently introduced to address the aforementioned procedural speed and the "ease of use" issues with using the principles of the segmental ablation technique. This study is done to report the early results after radiofrequency ablation with high ligation and using the ClosureFast catheter. METHODS: One hundred and nineteen limbs in 85 patients with great saphenous vein incompetence were treated between November, 2007 and June, 2009 with radiofrequency ablation with high ligation, and usually with adjunctive stab-avulsion phlebectomies. The patients were examined preoperatively and at 1 to 2 months postoperatively by using duplex sonography to determine the treatment's efficacy, as well as the adverse sequalae. RESULTS: The patients had an average age of 61.3+/-10.1 years (range, 32 to 80 years), and 22 (25.9%) were women. The pretreatment vein diameter measured in the supine position ranged from 5.0 to 20.0 mm (median, 8.5 mm). The total average operation time of the radiofrequency ablation with high ligation, except when performing phlebectomies, was 18.5+/-9.5 minutes. Serious complications such as deep vein thrombosis or neural injury were not observed. Paresthesia occurred in 7 limbs (5.8%). A thermal skin injury and thrombophlebitis were presented in one limb each, respectively, at the beginning period. The occlusion rate was 98.9% in 98 limbs on the follow-up at 1 to 2 months. CONCLUSION: Radiofrequency ablation with high ligation is feasible, safe and effective. However, long-term follow-up is needed in the future.