Endoluminal radiofrequency ablation of the long saphenous vein (VNUS closure) -- a minimally invasive management of varicose veins.
This report describes our clinical experience with the VNUS closure. This is a percutaneous catheter-based procedure in which the vein is ablated from within by resistive heating. We performed the UK's first radiofrequency closure without a high tie in March 1999. Between then and March 2000, 40 patients (35:5 F:M, age 22-92, mean 45.1 years) had 59 legs treated. All operations were for varicose veins, eight legs were recurrent, four legs had concomitant ulceration and three legs were treated with additional subfascial endoscopic perforator ligation (SEPS). Only one treatment failure occurred in our series. In all the other successfully treated limbs the long saphenous vein remained without flow on Duplex scan evaluation during our 1 year follow-up. All patients were fully mobile within 12 hours and all patients returned to their daily activities or to work within 72 hours. On questioning, no patient reported pain related to the thigh procedure. This new technique of radiofrequency ablation provides a minimal access alternative to the classical high saphenous tie and strip. Our results to date suggest that this procedure results in minimal post-operative pain and allows early return to normal activities.
Fassiadis
Department of Vascular Surgery Royal Surrey County Hospital Guildford, Surrey United Kingdom.
Holdstock
Whiteley