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Early Experience with Radiofrequency Ablation of the Greater Saphenous Vein

  • Papers Presented to the Southern California Vascular Surgical Society
  • Published:
Annals of Vascular Surgery

Abstract

Radiofrequency ablation of the greater saphenous vein (GSV) has been proposed as an alternative to conventional ligation and stripping in the treatment of varicose veins. We have reviewed our initial experience with this new technology in 28 procedures on 24 patients. Preoperative duplex scans confirmed venous valvular incompetence of the GSV in all patients. Intraoperative ultrasound was used to measure the depth of the GSV, to precisely place the radiofrequency catheter adjacent to the saphenofemoral junction, and to confirm the results of the ablative procedure. Occlusion of the GSV was seen on 96% of completion scans and in all patients within 1 week of the procedure. Duplex scans were available for 21 limbs at 3 months and for 3 at 1 year. Persistent occlusion was documented in all cases. No patient had paresthesias or thermal skin injury. Two patients had transient superficial thrombophlebitis around the knee in a treated segment of the GSV. One patient was found to have extension of an asymptomatic, nonocclusive thrombus into the common femoral vein on a routine scan 3 days after surgery. Postoperative patient questionnaires showed that 96% of respondents were very satisfied with the procedure. Radiofrequency ablation of the GSV appears to be a safe alternative to conventional stripping and ligation. Subjective assessment by the surgeons suggests an earlier return to work and active lifestyle compared to traditional extirpative techniques. Longer follow-up is required to establish the durability of the procedure.

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References

  1. JJ Bergan (2001) ArticleTitleEndovenous saphenous vein ablation. Adv Vasc Surg 9 123–132

    Google Scholar 

  2. SA Brethauer JD Murray DG Hatter et al. (2001) ArticleTitleTreatment of varicose veins: proximal saphenofemoral ligation comparing adjunctive varicose phlebectomy with sclerotherapy at a military medical center. Vasc Surg 35 51–58 Occurrence Handle11668369

    PubMed  Google Scholar 

  3. J Hammarsten P Pedersen C-G Cederlund et al. (1990) ArticleTitleLong saphenous vein saving surgery for varicose veins. Eur J Vasc Surg 4 361–364 Occurrence Handle2204548

    PubMed  Google Scholar 

  4. SR Munn JB Morton WAAG MacBeth et al. (1981) ArticleTitleTo strip or not to strip the long saphenous vein? A varicose vein trial. Br J Surg 68 426–428 Occurrence Handle1:STN:280:Bi6B3cfpsFA%3D Occurrence Handle7016244

    CAS  PubMed  Google Scholar 

  5. RH Samson JP Yunis DP Showalter (1998) ArticleTitleIs thigh saphenectomy a necessary adjunct to high ligation and stab avulsion phlebectomy? Am J Surg 176 168–171 Occurrence Handle10.1016/S0002-9610(98)00126-3 Occurrence Handle1:STN:280:DyaK1cvgslKnsQ%3D%3D Occurrence Handle9737625

    Article  CAS  PubMed  Google Scholar 

  6. LJ Fligelstone RA Salaman TO Oshodi et al. (1995) ArticleTitleFlush saphenofemoral ligation and multiple stab phlebectomy preserve a useful greater saphenous vein four years after surgery. J Vasc Surg 22 588–592 Occurrence Handle1:STN:280:BymD2s7osVA%3D Occurrence Handle7494360

    CAS  PubMed  Google Scholar 

  7. ML Friedell RH Samson MJ Cohen et al. (1992) ArticleTitleHigh ligation of the greater saphenous vein for treatment of lower extremity varicosities: the fate of the vein and therapeutic results. Ann Vasc Surg 6 5–8 Occurrence Handle1547077

    PubMed  Google Scholar 

  8. JJ Bergan (1996) ArticleTitleSaphenous vein stripping and quality of outcome. Br J Surg 83 1025–1027

    Google Scholar 

  9. S Dwerryhouse B Davies K Harradine et al. (1999) ArticleTitleStripping of the long saphenous vein reduces the rate of reoperation for recurrent varicose veins: five-year results of a randomized trial. J Vasc Surg 29 589–592 Occurrence Handle1:STN:280:DyaK1M3ht1Wjtg%3D%3D Occurrence Handle10194484

    CAS  PubMed  Google Scholar 

  10. L Jones BD Braithwaite D Selwyn et al. (1996) ArticleTitleNeovascularisation is the principal cause of varicose vein recurrence: results of a randomised trial of stripping the long saphenous vein. Eur J Vasc Endovasc Surg 12 442–445 Occurrence Handle1:STN:280:ByiC3svoslA%3D Occurrence Handle8980434

    CAS  PubMed  Google Scholar 

  11. PH Rutgers P Kitslaar (1994) ArticleTitleRandomized trial of stripping versus high ligation combined with sclerotherapy in the treatment of the incompetent greater saphenous vein. Am J Surg 168 311–315 Occurrence Handle7943585

    PubMed  Google Scholar 

  12. S Sarin JH Scurr PD Coleridge Smith (1992) ArticleTitleAssessment of stripping the long saphenous vein in the treatment of primary varicose veins. Br J Surg 79 889–893 Occurrence Handle1422747

    PubMed  Google Scholar 

  13. JJ Bergan (1998) ArticleTitleEvolution of varicose vein surgery. Adv Vasc Surg 6 81–91

    Google Scholar 

  14. M Durkin D Turton D Scott et al. (1999) ArticleTitleA prospective randomized trial of PIN versus conventional stripping in varicose vein surgery. Ann R Coll Surg Engl 81 171–174 Occurrence Handle1:STN:280:DyaK1M3ptlarsA%3D%3D Occurrence Handle10364948

    CAS  PubMed  Google Scholar 

  15. G Goren AE Yellin (1995) ArticleTitleMinimally invasive surgery for primary varicose veins: limited invaginated axial stripping and tributary (hook) stab avulsion. Ann Vasc Surg 9 401–414 Occurrence Handle1:STN:280:BymD2sjlt1E%3D Occurrence Handle8527344

    CAS  PubMed  Google Scholar 

  16. SS Chen NT Wright JD Humphrey (1998) ArticleTitleHeat-induced changes in the mechanics of a collagenous tissue: isothermal, isotonic shrinkage. J Biomech Eng 120 382–388 Occurrence Handle1:STN:280:DyaK1MzktV2itQ%3D%3D Occurrence Handle10412406

    CAS  PubMed  Google Scholar 

  17. JG Chandler O Pichot C Sessa et al. (2000) ArticleTitleTreatment of primary venous insufficiency by endovenous saphenous vein obliteration. Vasc Surg 34 201–214

    Google Scholar 

  18. S Manfrini V Gasbarro G Danielsson et al. (2000) ArticleTitleEndovenous management of saphenous vein reflux. J Vasc Surg 32 330–342 Occurrence Handle10.1067/mva.2000.107573 Occurrence Handle1:STN:280:DC%2BD3cvjvVGltg%3D%3D Occurrence Handle10917994

    Article  CAS  PubMed  Google Scholar 

  19. RA Weiss MA Weiss (2002) ArticleTitleControlled radiofrequency endovenous occlusion using a unique radiofrequency catheter under duplex guidance to eliminate saphenous varicose vein reflux: a 2-year follow-up. Dermatol Surg 28 38–42 Occurrence Handle10.1046/j.1524-4725.2002.01188.x Occurrence Handle11991268

    Article  PubMed  Google Scholar 

  20. J Sybrandy C Wittens (2002) ArticleTitleInitial experiences in endovenous treatment of saphenous vein reflux. J Vasc Surg 36 1207–1212 Occurrence Handle10.1067/mva.2002.128936 Occurrence Handle12469052

    Article  PubMed  Google Scholar 

  21. O Pichot C Sessa JG Chandler et al. (2000) ArticleTitleRole of duplex imaging in endovenous obliteration for primary venous insufficiency. J Endovasc Ther 7 451–459 Occurrence Handle1:STN:280:DC%2BD3M3htFCmsA%3D%3D Occurrence Handle11194816

    CAS  PubMed  Google Scholar 

  22. IK Komenaka ET Nguyen (2002) ArticleTitleIs there an increased risk for DVT with the VNUS closure procedure? [letter] J Vasc Surg 36 1311

    Google Scholar 

  23. RF Merchant RG DePalma LS Kabnick (2002) ArticleTitleEndovascular obliteration of saphenous reflux: a multicenter study. J Vasc Surg 35 1190–1196 Occurrence Handle10.1067/mva.2002.124231 Occurrence Handle12042730

    Article  PubMed  Google Scholar 

  24. SC Liew D Huber C Jeffs (1994) ArticleTitleDay-only admission for varicose vein surgery. Aust N Z J Surg 64 688–691 Occurrence Handle1:STN:280:ByqD3s7nslA%3D Occurrence Handle7945066

    CAS  PubMed  Google Scholar 

  25. GV Miller WG Lewis JR Sainsbury RC Macdonald (1996) ArticleTitleMorbidity of varicose vein surgery: auditing the benefit of changing clinical practice. Ann R Coll Surg Engl 78 345–349 Occurrence Handle1:STN:280:BymA3svntFQ%3D Occurrence Handle8712648

    CAS  PubMed  Google Scholar 

  26. JG Chandler O Pichot C Sessa et al. (2000) ArticleTitleDefining the role of extended saphenofemoral junction ligation: a prospective comparative study. J Vasc Surg 32 941–953 Occurrence Handle10.1067/mva.2000.110348 Occurrence Handle1:STN:280:DC%2BD3M%2FltlKjuw%3D%3D Occurrence Handle11054226

    Article  CAS  PubMed  Google Scholar 

  27. R Fischer N Linde C Duff et al. (2001) ArticleTitleLate recurrent saphenofemoral junction reflux after ligation and stripping of the greater saphenous vein. J Vasc Surg 34 236–240 Occurrence Handle10.1067/mva.2001.115802 Occurrence Handle11496274

    Article  PubMed  Google Scholar 

  28. T Rautio A Ohinmaa J Perälä et al. (2002) ArticleTitleEndovenous obliteration versus conventional stripping operation in the treatment of primary varicose veins: a randomized controlled trial with comparison of the costs. J Vasc Surg 35 958–965 Occurrence Handle10.1067/mva.2002.123096 Occurrence Handle12021712

    Article  PubMed  Google Scholar 

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Authors and Affiliations

  1. Division of Vascular Surgery, Cedars-Sinai Medical Center, Los Angeles, CA, USA

    Willis H. Wagner MD, Phillip M. Levin MD, David V. Cossman MD, Stephen R. Lauterbach MD, J. Louis Cohen MD & Alik Farber MD

Authors
  1. Willis H. Wagner MD
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  2. Phillip M. Levin MD
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  3. David V. Cossman MD
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  4. Stephen R. Lauterbach MD
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  5. J. Louis Cohen MD
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  6. Alik Farber MD
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Corresponding author

Correspondence to Willis H. Wagner MD.

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Wagner, W.H., Levin, P.M., Cossman, D.V. et al. Early Experience with Radiofrequency Ablation of the Greater Saphenous Vein . Ann Vasc Surg 18, 42–47 (2004). https://doi.org/10.1007/s10016-003-0095-x

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  • DOI: https://doi.org/10.1007/s10016-003-0095-x

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