title: Percutaneus treatment of varicose veins with bipolar radiofrequency ablation.
abstract: The traditional surgical treatment of an incompetent great saphenous vein (GSV) and small saphenous vein (SSV) is challenged by endovenous techniques. Bipolar radio frequency induced thermo therapy (RFITT) is a new endovenous treatment, which occludes the vein by using the venous wall as a conductor. Linear endovenous energy density (LEED) describes the amount of energy used for vein closure.
  
  
  METHODS
  From March 2007 till April 2009, two cohorts (23 W and 20 W) were compared, respectively 280 and 178 patients. GSV and SSV were separately analyzed. Follow-up was performed at 3 weeks and 1 year post-operatively with duplex ultrasound, to assess vein closure and perioperative complaints. A visual analog scale (VAS) pain score (range 0-10) was documented. For patients operated after October 2008 follow-up was performed at least 6 months after surgery.
  
  
  RESULTS
  528 GSV and 76 SSV were treated. For the GSV a significant difference in LEED 40.8 17.1 in the 20 W cohort was found, resulting in higher occlusion rates 90.6% compared to 82.7% after 3 weeks. Follow-up of 1 year in the 20 W cohort showed 88.7% occlusion. Multivariate analysis showed that pullback speed (OR 3.7, CI 1.1-12.4) and CEAP classification (OR 3.1, CI 1.7-5.6) were significant predictors for vein occlusion. Despite a higher LEED, post-operative complaints were not significantly worse.
  
  
  CONCLUSIONS
  RFITT is a safe and effective method to treat incompetent saphenous veins. Slower pullback speed with higher LEED results in higher closure rates without causing more pain.
authors.affiliation: Department of Surgery, Spaarne Hospital, Hoofddorp, The Netherlands.
authors.forename: R
authors.initials: R
authors.lastname: Boon
authors.forename: G J M
authors.initials: GJ
authors.lastname: Akkersdijk
authors.forename: D
authors.initials: D
authors.lastname: Nio
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000800:Angioplasty, Balloon / Q000379:methods*; D017115:Catheter Ablation / Q000379:methods*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D025321:Surgery, Computer-Assisted / Q000379:methods*; D014463:Ultrasonography; D014648:Varicose Veins / Q000000981:diagnostic imaging* / Q000601:surgery*