Short-term outcome analysis of radiofrequency ablation using ClosurePlus vs ClosureFast catheters in the treatment of incompetent great saphenous vein.

BACKGROUND

Radiofrequency ablation (RFA) is a widely accepted alternative to high ligation with proximal stripping of the great saphenous vein (GSV) in the treatment of lower extremity venous insufficiency. This study compared short-term outcomes of two generations of (VNUS Closure) RFA catheters, ClosurePlus (CP) and ClosureFast (CF).

METHODS

From February 2005 to April 2009, a total of 667 consecutive office-based RFA procedures were performed in our institution. CP catheters were used in the initial 312 lower extremity cases and CF catheters in the 355 cases that followed. The technique used for both catheters were as per the manufacturer's recommendations. Postoperative duplex scans were completed to document the following endpoints: GSV obliteration; incidence of deep venous thrombosis (DVT); superficial venous thrombosis (SVT); and presence of loose or floating thrombus proximal to the treated GSV segment.

RESULTS

Of the 667 cases, 98% had available duplex scan studies within 1 week from completion of the procedure. Complete obliteration of the GSV on duplex scan studies was noted in 98% of 343 cases using the CF catheter and 88% of 312 cases using the CP catheter (P < .001). No case of DVT was detected in those treated with the CF catheter, whereas DVT occurred in 3.5% of cases treated with the CP catheter (P < .001). Incidence of SVT was 10% and 15%, respectively, for CF and CP (P < .08). Loose thrombus proximal to the GSV was identified in 7% of cases using CF and 6% of cases using CP (P = .80). No embolic episodes were observed clinically.

CONCLUSIONS

CF catheters are superior to CP catheters in terms of GSV obliteration and nonincidence of postoperative DVT. The absence of DVT may likely be due to the commencement of ablation at 2 cm from the GSV-common femoral vein junction.