Treatment of the incompetent great saphenous vein by endovenous radiofrequency powered segmental thermal ablation: first clinical experience.
BACKGROUND
Radiofrequency ablation of saphenous veins has proven efficacy with an excellent side effect profile but has the disadvantage of a lengthy pullback procedure. This article reports a new endovenous catheter for radiofrequency-powered segmental thermal ablation (RSTA) of incompetent great saphenous veins (GSVs).


METHODS
A prospective, nonrandomized, multicenter study was conducted to evaluate the safety, feasibility, and early clinical outcomes of RSTA of the GSV.


RESULTS
A total of 194 patients with 252 GSVs with an average diameter of 5.7 +/- 2.2 mm (range, 2.0 to 18.0 mm) received RSTA under tumescent local anesthesia. In 58 patients (29.9%), bilateral treatment (average length treated, 36.7 +/- 10.8 cm) was done. The average total endovenous procedure time was 16.4 +/- 8.2 minutes, and the average total energy delivery time was 2.2 +/- 0.6 minutes. The corresponding endovenous fluence equivalent delivered to the proximal 7-cm vein segment was 82 +/- 25 J/cm(2) (range, 38 to 192). Follow-up at 3 days, 3 months, and 6 months was obtained from 250, 164, and 62 limbs, respectively. Occlusion rates were 99.6% for all three follow-up dates according to life-table analysis. The average Venous Clinical Severity Score was 3.4 +/- 1.2 at 3 days, 0.9 +/- 1.6 at 3 months, and 1.5 +/- 1.8 at 6 months compared with 3.9 +/- 2.0 at baseline.


CONCLUSIONS
Radiofrequency segmental thermal ablation is feasible, safe, and well tolerated.
Proebstle
Thomas Michael
TM
Department of Dermatology, University of Heidelberg, Heidelberg, Germany. Thomas.Proebstle@web.de
Vago
Bernadette
B
Alm
Jens
J
Göckeritz
Oliver
O
Lebard
Christian
C
Pichot
Olivier
O
D000328:Adult; D000368:Aged; D017115:Catheter Ablation / Q000009:adverse effects / Q000295:instrumentation; D005240:Feasibility Studies; D005260:Female; D005602:France; D005858:Germany; D006801:Humans; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D012501:Saphenous Vein / Q000000981:diagnostic imaging / Q000601:surgery*; D012720:Severity of Illness Index; D013997:Time Factors; D016896:Treatment Outcome; D014463:Ultrasonography; D014656:Vascular Surgical Procedures / Q000009:adverse effects / Q000295:instrumentation; D014689:Venous Insufficiency / Q000000981:diagnostic imaging / Q000601:surgery*