Article ID | Journal | Published Year | Pages | File Type |
---|---|---|---|---|
4227139 | European Journal of Radiology | 2010 | 5 Pages |
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 densitiy (LEED) describes the amount of energy used for vein closure.Material/methodsFrom 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.Results528 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.ConclusionRFITT 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.