Proebstle Thomas Michael, Vago Bernadette, Alm Jens, Göckeritz Oliver, Lebard Christian, Pichot Olivier
Department of Dermatology, University of Heidelberg, Heidelberg, Germany.
J Vasc Surg. 2008 Jan;47(1):151-156. doi: 10.1016/j.jvs.2007.08.056.
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).
A prospective, nonrandomized, multicenter study was conducted to evaluate the safety, feasibility, and early clinical outcomes of RSTA of the GSV.
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.
Radiofrequency segmental thermal ablation is feasible, safe, and well tolerated.
大隐静脉射频消融已证实疗效显著且副作用小，但存在回撤操作过程冗长的缺点。本文报道一种用于功能不全的大隐静脉射频驱动节段性热消融（RSTA）的新型静脉内导管。
进行了一项前瞻性、非随机、多中心研究，以评估大隐静脉RSTA的安全性、可行性和早期临床结果。
共有194例患者的252条大隐静脉接受了肿胀局部麻醉下的RSTA，平均直径为5.7±2.2mm（范围2.0至18.0mm）。58例患者（29.9%）接受了双侧治疗（平均治疗长度为36.7±10.8cm）。平均总静脉内操作时间为16.4±8.2分钟，平均总能量输送时间为2.2±0.6分钟。分别从250条、164条和62条肢体获得了3天、3个月和6个月的随访结果。根据生命表分析，所有三个随访日期的闭塞率均为99.6%。与基线时的3.9±2.0相比，3天时平均静脉临床严重程度评分为3.4±1.2，3个月时为0.9±1.6，6个月时为1.5±1.8。
射频节段性热消融是可行、安全且耐受性良好的。
