Naslov
Effectivness and tolerability of bipolar radiofrequency-induced thermotherapy for the treatment of incompetent saphenous veins

Autori
Camci, M. ; Harnoss, B. ; Akkersdijk, G. ; Braithwaite, B. ; Hnatek, L. ; Roche, E. ; Santoro, P. ; Šarlija, Mirko ; Sezgin, Y. ; Nio, D. ; Ajduk, Marko ; Koios, D.

Izvornik
Phlebologie (0939-978X) 38 (2009), 1; 5-11

Vrsta, podvrsta i kategorija rada
Radovi u časopisima, članak, znanstveni

Ključne riječi
Endovenous radiofrequency therapy; RFITT; saphenous vein varicosis; reflux

Sažetak
Endoluminal techniques such as laser therapy, radiofrequency therapy and sclerotherapy are increasingly replacing classic stripping for the treatment of incompetent saphenous veins. In- terim results of the ongoing international, multicentre BRITTIV study to investigate the ef- fectiveness and tolerability of the minimally in- vasive bipolar radiofrequency-induced thermal therapy (RFITT) are presented. Patients, meth- ods: A flexible bipolar RFITT applicator is pass- ed under ultrasound control into the affected vein of patients with varicosis of the great sa- phenous vein (GSV) or small saphenous vein (SSV). The vein is occluded by impedance-con- trolled release of radiofrequency energy as the RFITT applicator is slowly and smoothly with- drawn. The effectivness and tolerability of RFITT is checked over a one-year period by regular follow-ups. Results: To date a total of 345 saphenous veins (90% GSV, 10% SSV) in 271 patients (average age 50 years, 63% women, mean CEAP score 2.8) have been treated with RFITT in eight European hospitals. 72% of patients underwent general anaes- thesia (18% spinal, 11% local) and tumescent anaesthesia was also used in 83% of the veins (mean length 45 cm). The average application time was 1.4 s/cm with a mean power output of 24 Watt. At the interim analysis after an aver- age follow-up of 103 days, 90% of 335 treated veins were occluded. Differential analysis showed that partial (P) and complete (C) recur- rences occurred significantly less often when longer application times had been used, whereby complete recurrences showed a greater reduction in frequency than partial. The total recurrence rate with an application time < 1s/cmwas22% (P=10%, C=12%) ; withan application time between 1.0 and 1.4 s/cm it had already fallen to 9% (P = 6%, C = 3%) and with a time greater than 1.4 s/cm it was only 4% (P = 3%, C = 1%). According to subjective pain assessment on a visual analogue scale (VAS) of 0 to 10 (corresponding to no pain up to the strongest conceivable pain), by the first day after treatment already 74% of those questioned had only slight remaining pain or none at all (VAS 0–2). This generally low subjective pain sen- sation continued to fall at subsequent follow- ups and at the 6- month follow-up, 99% of pa- tients reported a VAS score of 0. Nearly all pa- tients (99%) were satisfied with the treatment and would recommend it to others. Conclusions: With the same power output, even a minor in- crease in the application time to more than 1.4 s/cm can markedly reduce recurrence rate. In summary, the ongoing BRITTIV study illustrates the potential of RFITT for use in phlebology as it combines a spatially-defined obliteration of in- competent saphenous veins with overall moder- ate side effects and impressive results.

Izvorni jezik
Engleski

Znanstvena područja
Kliničke medicinske znanosti

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