John J. Cranley Vascular Lab, Good Samaritan Hospital, Cincinnati, OH, USA.
Semin Vasc Surg. 2010 Jun;23(2):90-100. doi: 10.1053/j.semvascsurg.2010.01.004.
Superficial venous insufficiency of the lower extremities is a common affliction. There are several modalities available to the clinician to treat this problem. This article specifically examines the technique of radiofrequency ablation in the treatment of superficial venous insufficiency. The evolution of the catheters used in radiofrequency ablation is discussed in detail. The mechanism of action of the radiofrequency energy on the vein wall is explained. Several technical aspects of the technique, such as temperature set point and pull-back speed are described. The importance of tumescent anesthesia and its role in reducing complications are illustrated. Short- and long-term results of radiofrequency ablation are compared to results with both operative therapy or endovenous laser therapy, the results are similar if not better. Complications of radiofrequency ablation therapy are discussed, emphasizing the advent of tumescent anesthesia and the resultant drop in paresthesias. Outcome analysis of radiofrequency ablation is shown to have positive effects on both clinical-etiologic-anatomic-pathophysiologic class and venous clinical severity score. Finally other considerations, including billing and necessary supplies, are summarized. In summary, radiofrequency ablation is shown to be a safe and effective modality in the treatment of superficial venous insufficiency.
下肢浅静脉功能不全是一种常见疾病。临床医生有多种方法可用于治疗该问题。本文专门探讨了射频消融技术在治疗浅静脉功能不全中的应用。详细讨论了射频消融中使用的导管的演变。解释了射频能量对静脉壁的作用机制。描述了该技术的几个技术方面，例如温度设定点和后退速度。说明了肿胀麻醉的重要性及其在减少并发症中的作用。将射频消融的短期和长期结果与手术治疗或静脉内激光治疗的结果进行了比较，如果不是更好，结果也是相似的。讨论了射频消融治疗的并发症，强调了肿胀麻醉的出现以及由此导致的感觉异常减少。结果分析表明，射频消融对临床病因解剖病理生理分级和静脉临床严重程度评分均有积极影响。最后，总结了其他考虑因素，包括计费和必要的用品。总之，射频消融技术在治疗浅静脉功能不全方面是一种安全有效的方法。
