Results of endovenous ClosureFast treatment for varicose veins in an outpatient setting.

OBJECTIVE: Endovenous methods are increasingly used to treat varicose veins. We evaluated the outcome of patients treated with the new radiofrequency ablation (RFA)-ClosureFast catheter in an outpatient setting. METHOD: Retrospective analysis of postinterventional duplex ultrasound (DUS), complication rate and quality of life of patients treated for incompetent saphenous veins. RESULTS: Between 2007 and 2009, 155 patients had been treated with ClosureFast. DUS was available from 73 (47%) patients (102 great [GSV] and 16 small [SSV] saphenous veins). After a mean follow-up of 12.2 months (range 1-29 months), DUS showed six (5.9%) open GSV and an occlusion of all treated SSV. One pulmonary embolism had occurred. Mean patient's satisfaction was 8.7 (10 = very satisfied), pain after one week 2.0 (no pain = 0, maximal = 10) and absence of work was 0.9 day (range 0-14 days). CONCLUSION: RFA for incompetent saphenous veins can safely be performed in an outpatient setting with a low complication rate, minimal pain and fast recovery.

Treatment of varicose veins with minimally invasive methods: is conventional surgery still a "gold standard"?

AIM: To assess the current role of thermal ablation in the treatment of saphenous reflux in comparison to more conventional methods. METHOD: Some pertinent publications are presented as well as the author's experience with thermal ablation using ClosureFast. RESULTS: Over the last decade several techniques for thermal ablation of saphenous reflux have been developed. There is some evidence--although scarce--that thermal ablation was from the start not inferior to standard surgery (high ligation and stripping). In addition, more recent thermal ablation techniques appear to have milder side effects than the pioneers. CONCLUSION: Thermal ablation of saphenous reflux has quickly assumed an important role in the treatment of varicose veins and the parameters of thermal ablation may further be optimised. Therefore, we believe that high ligation and stripping of refluxing saphenous veins will widely be displaced by thermal ablation.

Bifurcation to worms in electroconvection.

The primary bifurcation to electroconvection of the liquid crystal 4-ethyl-2-fluoro-4'-[2-(trans-4-pentylcyclohexyl)ethyl]-biphenyl (I52) with planar alignment leads to localized structures of convection rolls known as "worms" when the conductivity of the fluid is relatively small. Worms coexist with the conduction state. They have a unique small width in the direction perpendicular to the director and a varying, usually much greater, length parallel to the director. Previous experiments had not determined whether the bifurcation to worms is supercritical or subcritical. We estimated the voltage V(c) corresponding to the stability limit of the conduction state by measuring the mean-square amplitude of the thermally induced fluctuations below onset and extrapolating to V(c). We found that worms appear already well below V(c). Thus the bifurcation is subcritical. Measurements of the lifetime of the conduction state below V(c) gave information about the voltage V(s) corresponding to the saddle node below which no worms form. We measured V(c) and epsilon(s)=V(s)2/V(c)2-1 as a function of the conductance sigma for a cell of thickness 24 microm and found for our sample that epsilon(s) approaches zero from negative values near sigma approximately 1.2 x 10(-8) Omega(-1) m(-1) as sigma increases. For larger sigma we found the bifurcation to be supercritical. We have been unable to determine so far whether the experimentally observed transition with decreasing sigma from a supercritical to a subcritical bifurcation occurs via a tricritical bifurcation, or whether the worm saddle node is disconnected from the primary supercritical bifurcation line as suggested by theory.