Endovenous radiofrequency ablation (venefit procedure): impact of different energy rates on great saphenous vein shrinkage.

BACKGROUND: Despite adequate treatment of varicose veins, recurrences and primary failures still occur. This article hypothesizes that increasing the dose of radiofrequency ablation (RFA) could improve efficacy through inducing a greater shrinkage of the treated vein. METHODS: A comparative clinical study of 67 extremities with varicose veins caused by great saphenous vein (GSV) reflux treated with RFA ClosureFAST was conducted. Group 1 (n = 22) received 1 treatment cycle (20 sec) and group 2 (n = 45) received 2 cycles (40 sec) along the GSV trunk. Clinical and duplex follow-up were performed at day 4, and at 1, 3, and 6 months. The main outcomes measured were GSV diameters, occlusion rate, and secondary effects. Statistical analysis was performed using the Student's t test, linear mixed model, Bland-Altman plot, Lin's concordance correlation coefficient, and intraclass correlation coefficient. RESULTS: Both groups were comparable for demographic and specific study variables with a very low intraobserver variability. The immediate occlusion rate was 100% for both groups. Group 2 showed a quicker and greater reduction in medium diameter along the period of the study (P = 0.0074). Beyond the 6-month period of study, 1 partial GSV recanalization in group 1 and 1 complete GSV recanalization in an obese patient in group 2 were detected. No skin burns, paresthesia, or deep vein thromboses appeared. CONCLUSIONS: Two cycles of RFA treatment in all segments of the GSV achieves quicker and greater vein shrinkage of the medium diameter without an increase in side effects. Further studies are needed to evaluate the implications in terms of intermediate and long-term clinical efficacy.

Update on endovenous radio-frequency closure ablation of varicose veins.

Until recent years, the gold standard for treatment of truncal varicose veins has been high ligation and stripping of the saphenous vein. In the course of the last decade, new minimally invasive techniques based on endothermal ablation are progressively supplanting conventional surgery in the treatment of varicose veins. The endovenous treatment of varicose veins has been developed to reduce complications associated with conventional surgery and to improve quality of life. Radio frequency ablation (RFA) available since 1999 is now established as a safe and efficacious treatment for the ablation of refluxing saphenous veins. Among the emerging therapies, RFA with VNUS ClosureFAST is promising because it has eliminated almost all disadvantages associated with conventional surgery by "stripping" (bruises, scars, ecchymosis, inguinal recurrence, neovascularization, and mainly, prolonged incapacity) with an immediate occlusion rate close to 100%. When it is compared with endovenous laser ablation, RFA technology is associated with less postprocedural pain, less ecchymosis and tenderness, and better quality of life (QOL) measures. The aim of this article is to summarize the available evidence in the RFA treatment of varicose veins.

Nuevos avances el el tratamiento de las varices: radiofrecuencia endovenosa VNUS Closure / New advances in the treatment of varicose veins: endovenous radiofrequency VNUS Closure

Las varices de las extremidades inferiores frecuentemente son secundarias a insuficiencia de la vena safena interna (VSI). El desarrollo tecnológico ha permitido la aparición de nuevos tratamientos mínimamente invasivos como la ablación por radiofrecuencia endovenosa (RFA). Esta elimina casi en su totalidad los inconvenientes asociados a la cirugía convencional (hematomas, cicatrices, neovascularización inguinal e incapacidad laboral prolongada). Además, confiere mejor calidad de vida, menor dolor e inflamación que el endoláser. Revisamos la RFA y presentamos nuestros resultados como grupo pionero en España. Entre enero de 2006 y 2011 hemos tratado 153 extremidades con un diámetro medio VSI 6,8mm (rango 4,5-19). El 71% de procedimientos fueron realizados exclusivamente bajo anestesia tumescente. El 98,5% sin abordaje quirúrgico inguinal. Seguimiento clínico y ecográfico con registro prospectivo 1.ª semana, 3, 6, 12 meses, y anualmente. Resultados: tasa de oclusión vena tratada 97%, tasa de reflujo 6,6%. Neovascularización inguinal 0,7%. No neuritis, quemadura cutánea, ni trombosis venosa profunda

Lower limb varicose veins are often secondary to greater saphenous vein (GSV) insufficiency. Technological development has led to the appearance of new minimally invasive treatments, such as endovenous radiofrequency ablation (ERFA). This almost completely eliminates the disadvantages associated with conventional surgery (haematomas, scars, inguinal neovascularisation, and a prolonged time off work). Furthermore, it gives a better quality of life, less pain and inflammation than the endolaser. We review ERFA and present our results as a pioneering group in Spain. Between January 2006 and 2011 we have treated153 limbs with a mean GSV diameter of 6.8 mm (range 4.5-19). Tumescent anaesthesia was exclusively used in 71% of the procedures, and 98.5% without an inguinal surgical approach. Clinical and ultrasound follow-up with a prospective register was performed at 1 week, 3, 6,12 months, and then annually. Results: The occlusion rate of the treated vein was 97%, and there was a reflux rate of 6.6%. Inguinal neovascularisation was present on 0.7%. There was no neuritis, skin burns or deep vein thrombosis (AU)

[New advances in the treatment of varicose veins: endovenous radiofrequency VNUS Closure®]. / Nuevos avances el el tratamiento de las varices: radiofrecuencia endovenosa VNUS Closure(®).

UNLABELLED: Lower limb varicose veins are often secondary to greater saphenous vein (GSV) insufficiency. Technological development has led to the appearance of new minimally invasive treatments, such as endovenous radiofrequency ablation (ERFA). This almost completely eliminates the disadvantages associated with conventional surgery (haematomas, scars, inguinal neovascularisation, and a prolonged time off work). Furthermore, it gives a better quality of life, less pain and inflammation than the endolaser. We review ERFA and present our results as a pioneering group in Spain. Between January 2006 and 2011 we have treated 153 limbs with a mean GSV diameter of 6.8 mm (range 4.5-19). Tumescent anaesthesia was exclusively used in 71% of the procedures, and 98.5% without an inguinal surgical approach. Clinical and ultrasound follow-up with a prospective register was performed at 1 week, 3, 6, 12 months, and then annually. RESULTS: The occlusion rate of the treated vein was 97%, and there was a reflux rate of 6.6%. Inguinal neovascularisation was present on 0.7%. There was no neuritis, skin burns or deep vein thrombosis.