Endovenous obliteration with radiofrequency-resistive heating for greater saphenous vein insufficiency: a feasibility study.
OBJECTIVE
To assess the feasibility, safety, and clinical utility of ultrasound (US)- and fluoroscopy-guided endovenous saphenous vein obliteration with radiofrequency (RF)-resistive heating in the treatment of primary venous insufficiency.


METHODS
Thirty legs of 27 patients with mild to moderate varicose veins and primary greater saphenous vein (GSV) insufficiency diagnosed with duplex US were treated. An endovenous catheter was inserted via US-guided percutaneous puncture or a skin incision. Fluoroscopy and US were used to locate the electrodes at the saphenofemoral junction. GSVs were occluded with RF-resistive heating. Local phlebectomies or sclerotherapy were performed in all procedures to treat varicose veins and teleangiectases. Persistence of vein occlusion and complications potentially attributable to endovenous treatment were assessed at 1 week, 6 weeks, 3 months, 6 months, and 1 year.


RESULTS
The mean follow-up time was 9.6 months (SD, 3.8 mo). By the time of the last follow-up visit, occlusion of the treated segment of the GSV had been achieved in 22 legs (73.3%). Persisting patency or recanalization of the GSV was detected in eight legs (26.7%). One patient (3.3%) had varicosity-related symptoms, and three treated legs (10%) had recurrent or new varicosities. Postoperative complications included saphenous nerve paresthesia in three legs (10%) and thermal skin injury in one limb (3.3%).


CONCLUSIONS
Endovenous obliteration employing RF-resistive heating is a relatively safe and promising minimally invasive technique for the treatment of primary GSV insufficiency.
Rautio
Tero T
TT
Departments of Surgery, University of Oulu, P.O. Box 5000, 90014 Oulu, Finland. tero.rautio@oulu.fi
Perälä
Jukka M
JM
Wiik
Heikki T
HT
Juvonen
Tatu S
TS
Haukipuro
Kari A
KA
D000328:Adult; D017115:Catheter Ablation / Q000379:methods*; D005240:Feasibility Studies; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D012501:Saphenous Vein / Q000000981:diagnostic imaging* / Q000601:surgery*; D018615:Ultrasonography, Doppler, Color; D014689:Venous Insufficiency / Q000000981:diagnostic imaging* / Q000601:surgery*