Endovenous radiofrequency obliteration of the saphenous veins in the treatment of venous insufficiency of lower legs. Personal experience

Abstract

OBJECTIVE: To determine the efficacy and safety of endovascular radiofrequency obliteration of refluxing greater saphenous veins in patients eligible for vein ligation and stripping.

MEHOD: From 2002 to 2007, 107 patients, classified a C2 CEAP, were treated. The ablation of the greater saphenous vein was performed using a radiofrequency generator and a VNUS Closer catheter, for endovascular radiofrequency ablation. This procedure avoids groin surgery. The catheter is inserted in the saphenous vein with the use of a introducer through the skin. When necessary, the procedure was complemented by phlebectomy (Muller’s method). In all cases, the duplex/color ultrasound was used in guiding the pre- intra and post-operative phase.

RESULTS: The procedure was carried out in all cases without complicatons, with immediate improvament of clinical symptoms and immediate return to normal activities. At 5-year follow-up no recurrent varicose veins were detected.

CONCLUSIONS: The endovenous radiofrequency ablation of the saphenous veins represents a valid alternative to GSF ligation and savenous vein stripping. The rigorous application of the protocol, both before and after the operation, is an essential condition to keep complications to a minimum. Because of the long term results, the level of patient satisfaction, the ease with which the procedure is carried out, we have extended its adoption to patients with an advanced stage of the disease, whom in the past would have only been treated with stripping.