Fifteen Year Results of Radiofrequency Ablation, Using VNUS Closure, for the Abolition of Truncal Venous Reflux in Patients with Varicose Veins

Whiteley, Mark S; Shiangoli, Irenie; Santos, Scott J Dos; Dabbs, Emma B; Fernandez-Hart, Tim J; Holdstock, Judy M

doi:10.1016/j.ejvs.2017.06.001

Cited by 39 publications

(26 citation statements)

References 29 publications

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“…Fiveyear results from the prospective European multicenter cohort study RFA using the Venefit procedure showed GSV occlusion rate of 91.9% with 94.9% reflux free GSVs. 3 Recently, Whitely et al 42 reported an 88% success with no recurrence in the originally treated truncal veins, 15 years post RFA, as demonstrated by duplex. Other RFA systems are available (RFITT, Olympus, Germany and Venclose, USA), but the long-term efficacy is still less documented.…”

Section: Radiofrequency Ablationmentioning

confidence: 97%

European College of Phlebology guideline for truncal ablation

et al. 2019

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Background The purpose of the guideline was to achieve consensus in the care and treatment of patients with chronic venous disease, based on current evidence. Method A systematic literature search was performed in PubMed, Embase, Cinahl, and the Cochrane library up until 1 February 2019. Additional relevant literature were added through checking of references. Level of evidence was graded through the GRADE scale and recommendations were concluded. Results For the treatment of great and small saphenous vein reflux, endovenous ablation with laser or radiofrequency was recommended in preference to surgery or foam sclerotherapy. If tributaries are to be treated it should be done in the same procedure. Treatment with mecanicochemical ablation and glue can be used but we still need long term follow up results. Conclusion For the treatment of truncal varicosities, endovenous ablation with laser or radiofrequency combined with phlebectomies is recommended before surgery or foam.

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Section: Radiofrequency Ablationmentioning

confidence: 97%

European College of Phlebology guideline for truncal ablation

et al. 2019

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“…2,3 The safety and efficacy of endothermal ablation of truncal saphenous veins have been demonstrated 4 and recent unrivalled 15-year follow-up data using radiofrequency ablation (RFA) have shown excellent durable longterm technical success. 5 However, thermal techniques require the use of peri-venous tumescence to provide anaesthesia and to protect surrounding tissues from thermal injury. Tumescence administration, although generally well-tolerated, requires multiple injection sticks along the course of the saphenous vein, which can cause both intra-procedural and post-operative discomfort 6 as well as adverse events such as haematoma and ecchymosis.…”

Section: Introductionmentioning

confidence: 99%

Endovenous cyanoacrylate glue to treat varicose veins and chronic venous insufficiency—Experience gained from our first 100+ truncal venous ablations in a multi-ethnic Asian population using the Medtronic VenaSeal™ Closure System

et al. 2019

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Objectives The aim of this prospective single-centre study is to assess the effectiveness and patient experience of the VenaSeal™ Closure System, a novel non-thermal, non-tumescent catheter technique, which uses cyanoacrylate glue to occlude the refluxing truncal superficial veins to treat varicose veins and chronic venous insufficiency, in a multi-ethnic Asian population from Singapore. Methods Seventy-seven patients (93 legs; 103 procedures) underwent VenaSeal™ Closure System ablation. Forty-nine (63.6%) for great saphenous vein incompetence, 16 (20.8%) bilateral great saphenous vein, 2 (2.6%) small saphenous vein and 10 (13.0%) combined unilateral great saphenous vein and small saphenous vein/anterior thigh vein reflux. In addition, 65/93 legs (69.9%) had C4–C6 disease. Patients were reviewed at 2 weeks, 3, 6 and 12 months post-procedure. Results There was 100% technical success. 28/77 (36.4%) underwent concomitant phlebectomies. All procedures were well tolerated with a mean post-operative pain score of 3.0 (range: 0–5). After three months, median patient satisfaction was 9.0 (interquartile range: 7.0–10.0). At two-week follow-up, the great saphenous vein was completely occluded in 88/88 (100%) veins and small saphenous vein completely closed in 11/11 (100%) veins. At three-month follow-up, the great saphenous vein was occluded in 51/53 (96.2%) veins and small saphenous vein completely closed in 5/5 (100%) veins. At six-month follow-up, the great saphenous vein was completely occluded in 42/45 (93.3%) veins and small saphenous vein completely closed in 5/7 (71.4%) veins. At one year, great saphenous vein and small saphenous vein occlusion rates were 54/59 (91.5%) and 5/8 (62.5%), respectively. There was one deep vein thrombosis. Transient superficial phlebitis was reported in 10/93 (10.8%) legs, which were all self-limiting. There were 9/103 (8.7%) anatomical recurrences, but no patients required re-intervention as they were asymptomatic. Conclusions Cyanoacrylate glue is a safe and efficacious modality to ablate refluxing saphenous veins in Asian patients in the short term. There is a high satisfaction rate and peri-procedural pain is low. Early results are promising but further evaluation and longer term follow-up are required.

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“…Also, RF procedure results seem to be stable for longer periods after the procedure. Proebstle et al reported a high occlusion rate of 91.9% of treated veins after five years of follow-up [43], while the study of the longest observation time after EVTA showed a rate of 88.1% of technical success 15 years after RF VNUS closure [44].…”

Section: Long-term Resultsmentioning

confidence: 99%

Are non-thermal, non-tumescent techniques more recommended? Endovenous treatment of saphenous veins reflux – methods and results overview and discussion

Zieliński¹,

Świercz²

2018

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Chronic venous disease is one of the biggest health problems of today's word. The consequences of the progression of venous disorders can lead to severe acute complications like superficial venous thrombosis, deep vein thrombosis, and pulmonary embolism, as well as chronic venous ulcers. The costs of the treatment of these conditions are still growing. The development of minimally invasive techniques has led to huge progress in the treatment of chronic venous disease. There are many modalities in the phlebological armamentarium, which can be chosen to eliminate axial reflux that is responsible for the progression of disease in the majority of cases. Various groups of techniques can be used: thermal and tumescent procedures, non-thermal tumescent options, or non-thermal non-tumescent treatment. In recent years special interest has been directed towards non-thermal, non-tumescent modalities, following suggestions that these procedures would create the same effects as thermal-tumescent ones, but are less invasive and give the patient a better outcome and quality of life. The review of recently published studies did not confirm this theory in general; however, some superiority of these options is present. Thus, further investigations and trials on this issue are highly recommended. Currently there is not enough strong evidence to promote non-thermal, non-tumescent techniques over other endovenous modalities.

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Fifteen Year Results of Radiofrequency Ablation, Using VNUS Closure, for the Abolition of Truncal Venous Reflux in Patients with Varicose Veins

Abstract: RFA with VNUS Closure achieved excellent long-term technical success in treating venous reflux in truncal veins 15 years post-procedure, demonstrated by DUS. This bodes well for the increased use of EVTA in treating truncal vein reflux.

Cited by 39 publications

References 29 publications

European College of Phlebology guideline for truncal ablation

European College of Phlebology guideline for truncal ablation

Endovenous cyanoacrylate glue to treat varicose veins and chronic venous insufficiency—Experience gained from our first 100+ truncal venous ablations in a multi-ethnic Asian population using the Medtronic VenaSeal™ Closure System

Are non-thermal, non-tumescent techniques more recommended? Endovenous treatment of saphenous veins reflux – methods and results overview and discussion

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