Endovenous radiofrequency ablation of saphenous vein reflux. The VNUS Closure procedure with Closurefast. An updated review.

Endovenous treatment is progressively supplanting open surgery in treatment of saphenous reflux. Among the emerging techniques the VNUS Closure, procedure with ClosureFast is one of the most promising. The aim of the presente review is to remind the principle of radiofrequency action in varicose vein treatment, to describe the procedure achievement including the devices used generator and catheter and finally to report the published studies on ClosureFast. A research in the published literature identified only two articles reporting the outcome of procedure. The first one, a prospective, non-randomized international multicenter prospective clinical trial includes 296 great saphenous veins treated by radiofrequency with the ClosureFAST catheter under tumescent anesthesia. Occlusion rate at 6 months (62 extremities) was achieved in 99.6% with no recanalisation since the first ultrasound assessment at 3 days. The Venous Clinical Severity Score was significantly improved at 6 months compared with the baseline one. No serious adverse events were reported. The second one RECOVERY trial was a multicenter prospective randomized comparative clinical trial of the ClosureFAST catheter and endovenous 980-nm laser ablation including 69 patients. Final results showed patients treated with the ClosureFAST catheter experienced significantly less post-procedure pain, bruising and tenderness when compared to laser ablation, There were statistically fewer complications in limbs treated with the ClosureFAST catheter compared to laser ablation (P=0.021). In conclusion radiofrequency segmental thermal ablation with ClosureFAST catheter is feasible, safe, and well tolerated. Procedure is shortened and short-term results are better than those provided by the previous Closure catheter. A randomized control trial ClosureFAST versus endovenous laser is in favour of the first one.