Radio wave therapy

Minimally invasive, endovenous therapy option for the elimination of stem varices, side branches, recurrent varices

The active principle is to destroy the tissue of the vein wall by high heat. The electronic radio waves are generated in a generator and transmitted to a catheter. The electrodes at the tip of the catheter have a temperature of 60 to 120 degrees Celsius - depending on the catheter.

Burns and hypaesthesia.

Postoperative recanalization rate: the data in various languages Studies on the postoperative recanalization rate after 6-60 months are on average 10.9%. In a meta-analysis van den Bos gives the success rate of radio wave therapy after an average follow-up of 32.2 months as 84%.

The occlusion rates remain stable over the years.

Radiofrequency therapy has been approved for the treatment of truncal varicosis in Germany since 1998.

There are currently several procedures on the market. The two most important are:

1. VNUS-Closure Fast or new Venefit - Segmental thermal ablation to eliminate insufficient veins. Energy output, radiation time and local exposure time are programmed on the generator. Incorrect application almost impossible. The catheter has a lumen through which - before the catheter is activated - foam sclerotherapy can be performed additively. Catheter available in 60 and 100cm length with 3 or 7cm heating element.

2. RFITT or Celon method - electrodes are arranged bipolar. A high-frequency alternating current creates a microwave effect in the vein wall. Continuous retraction. For orientation a signal sounds, which should be constant. If the retraction is too fast or too slow, the sound stops or at the same time the temperature output is interrupted. Procedure requires practice. Catheter does not have a hollow space, is 100cm long.

1. Hartmann K et al (2015) Endovenous procedures. Schattauer publishing house. Stuttgart.

2. Lane T et al. (2016) A multi-centre randomised controlled trial comparing radiofrequency and mechanical occlusion chemically assisted ablation of varicose veins - Final results of the Venefit versus Clarivein for varicose veins trial. Phlebology pii: 0268355516651026.

3. Pichot O et al (2004) Duplex ultrasound scan findings two years after great saphenous vein radiofrequency endovenous obliteration. J Vasc Surgery 39: 189-195

4. Proebstle TM et al (2015) Five-year results from the prospective European multicentre cohort study on radiofrequency segmental thermal ablation for incompetent great saphenous veins. Br J Surg 102:212-218.

5. Van den Bos RR et al (2009) Endovenous laser ablation-induced complications: review of the literature and new cases. Dermatol Surg 35:1206-1214
6. Weiss RA, Weiss MA (2002) Controlled radiofrequency endovenous occlusion using a unique radiofrequency catheter under duplex guidance to eliminate saphenous varicose vein reflux: a 2-year follow-up. Dermatol Surgery 28: 38-42