Percutaneus treatment of varicose veins with bipolar radiofrequency ablation
Received 25 March 2010; accepted 31 March 2010.
Abstract
The traditional surgical treatment of an incompetent great saphenous vein (GSV) and small saphenous vein (SSV) is challenged by endovenous techniques. Bipolar radio frequency induced thermo therapy (RFITT) is a new endovenous treatment, which occludes the vein by using the venous wall as a conductor.
Linear endovenous energy densitiy (LEED) describes the amount of energy used for vein closure.
Material/methods
From March 2007 till April 2009, two cohorts (23W and 20W) were compared, respectively 280 and 178 patients. GSV and SSV were separately analyzed. Follow-up was performed at 3 weeks and 1 year post-operatively with duplex ultrasound, to assess vein closure and perioperative complaints. A visual analog scale (VAS) pain score (range 0–10) was documented. For patients operated after October 2008 follow-up was performed at least 6 months after surgery.
Results
528 GSV and 76 SSV were treated. For the GSV a significant difference in LEED 40.8 17.1 in the 20W cohort was found, resulting in higher occlusion rates 90.6% compared to 82.7% after 3 weeks. Follow-up of 1 year in the 20W cohort showed 88.7% occlusion. Multivariate analysis showed that pullback speed (OR 3.7, CI 1.1–12.4) and CEAP classification (OR 3.1, CI 1.7–5.6) were significant predictors for vein occlusion. Despite a higher LEED, post-operative complaints were not significantly worse.
Conclusion
RFITT is a safe and effective method to treat incompetent saphenous veins. Slower pullback speed with higher LEED results in higher closure rates without causing more pain.
ABSTRACT