Long-term results after radiofrequency ablation in 1998

Summary

Introduction: In 1998, radiofrequency ablation (VNUS Closure Plus™) was authorised in Germany and Europe for the treatment of superficial reflux. We participated in a clinical registry set up by the manufacturing company in 1998. The aim of this retrospective paper was to analyse the long-term results after radiofrequency ablation.

Materials, methods and patients: In 1998, we operated on twelve patients (8 women, 4 men). In accordance with the concept of standard vein stripping surgery, all endovenous ablations were combined with crossectomy or ligature of the saphenopopliteal junction. Each vein was thermally ablated over its entire length and no tumescent anaesthesia was performed. The mean age of the twelve patients was 44.9 years. On ten occasions, the entire length of the great saphenous vein was treated, on one occasion the great saphenous vein at the level of the lower leg and on one occasion the entire length of the small saphenous vein. The mean duration of surgery was 80 minutes.

Results: The follow-up period was 3 to 168 months, with a mean duration of 80 months. Six patients were followed up for longer than 120 months. In eight cases, the follow-up examination was performed using duplex ultrasound, in two cases using clinical examination and non-invasive testing, in one case using clinical examination and in one case via a telephone interview.

The most frequent perioperative complication, occurring in six cases, was hypaesthesia at the medial malleolus or lower leg. There was one case of perioperative thrombophlebitis of a lateral branch in the lower leg and one case of a third-degree thigh burn with subsequent infection of the great saphenous vein canal. No deep vein thrombosis or pulmonary embolism occurred in any of the operated patients.

Of the eleven great saphenous veins treated, one recanalised after 14 months, the others had closed or were no longer detectable on ultrasound. The small saphenous vein treated was also no longer detectable.

In one patient, a major recurrence at the saphenofemoral junction with recurrent lateral branches in the thigh and lower leg were determined 168 months after surgery. No recurrent varicosis was determined in the other patients.

Keywords

Radiofrequency ablation - long-term results - follow-up

• References

• 1 Almeida JI. et al. Radiofrequency Endovenous ClosureFAST versus laser ablation for the treatment of great saphenous reflux (RECOVERY Study). J Vasc Interv Radiology 2009; 20: 752-775.
• 2 Lübke T, Gawenda M, Heckenkamp J, Brunkwall J. Meta-analysis of endovenous radiofrequency obliteration of the great saphenous vein in primary varicosis. J Endovasc Ther 2008; 15: 213-223.
• 3 Lurie F, Creton D, Eklof B. et al. Prospective randomized study of endovenous radiofrequency obliteration (Closure) versus ligation and vein stripping (ELVOLVES): two-year follow-up. Eur J Vasc Endovasc Surg 2005; 29: 67-73.
• 4 Noppeney T, Noppeney J, Winkler M. Update der Ergebnisse nach Radiofrequenzablation zur Ausschaltung der Varikose. Gefäßchirurgie 2008; 13: 258-264.
• 5 Proebstle TM, Vago B, Alm J. et al. Treatment of the incompetent great saphenous vein by endovenous radiofrequency powered segmental ablation: first clinical experience. J Vasc Surg 2008; 47: 151-156.
• 6 Proebstle TM, Alm J, Göckeritz O. et al. European Closure Fast Clinical Study Group. J Vasc Surg 2011; 54 (01) 146-152.
• 7 van den Bos R, Arends L, Kockaert M. et al. Endovenous therapies of lower extremity varicosities: a metaanalysis. J Vasc Surg 2009; 49: 230-239.