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S A S Hamann, L Timmer-de Mik, W M Fritschy, G R R Kuiters, T E C Nijsten, R R van den Bos
BACKGROUND: The current treatment strategy for many patients with varicose veins is endovenous thermal ablation. The most common forms of this are endovenous laser ablation (EVLA) and radiofrequency ablation (RFA). However, at present there is no clear consensus on which of these treatments is superior. The objective of this study was to compare EVLA with two forms of RFA: direct RFA (dRFA; radiofrequency-induced thermotherapy) and indirect RFA (iRFA; VNUS ClosureFast™). METHODS: Patients with symptomatic great saphenous vein (GSV) incompetence were randomized to receive EVLA, dRFA or iRFA...
May 16, 2019: British Journal of Surgery
M D Dibirov, A I Shimanko, R U Gadzhimuradov, A S Volkov, D S Tiurin, A Kh Magdiev
Analysed herein are the results of using radiofrequency ablation (RFA) in comprehensive surgical treatment of patients presenting with varicose veins of the lower extremities. The study included a series of ninety-eight 28-to-60-year-old patients (with a total of 105 operations performed) suffering from varicose veins of the lower limbs. Of these, there were 10 men (10.3%) and 88 women (89.7%). Venous disease of clinical class C2 according to the CEAP classification was diagnosed in 80 patients, that of class C3 in 17, and that of class C4a in 1 patient...
2018: Angiology and Vascular Surgery
M S Whiteley, I Shiangoli, S J Dos Santos, E B Dabbs, T J Fernandez-Hart, J M Holdstock
OBJECTIVES: Endovenous thermal ablation (EVTA) of varicose veins was introduced in the late 1990s with radiofrequency ablation (RFA) using the VNUS Closure device. The results of the original VNUS Closure device for the abolition of truncal venous reflux at 15 years are reported. METHODS: A prospective audit of a group of patients treated with VNUS Closure 15 years previously was carried out, using clinical assessment and duplex ultrasound. A total of 189 patients were treated with VNUS Closure between March 1999 and December 2001 and were invited for clinical assessment (subjective and objective) and duplex ultrasonography (DUS) to assess treatment outcome and de novo disease progression...
September 2017: European Journal of Vascular and Endovascular Surgery
Shaun M Gifford, Manju Kalra, Peter Gloviczki, Audra A Duncan, Gustavo S Oderich, Mark D Fleming, Scott Harmsen, Thomas C Bower
BACKGROUND: Intervention on the great saphenous vein (GSV) has traditionally been limited to the above-knee (AK-GSV) segment for fear of saphenous neuralgia in spite of incompetence demonstrated in the below-knee (BK-GSV) segment. Residual symptoms and need for reintervention are reported to result in nearly half the patients if the refluxing BK-GSV is ignored. Experience with endovenous ablation of the BK-GSV at the time of AK-GSV treatment is sparsely reported in the literature. The aim of this study was to evaluate the safety of endovenous ablation of the refluxing BK-GSV...
October 2014: Journal of Vascular Surgery. Venous and Lymphatic Disorders
Meghan Dermody, Thomas F O'Donnell, Ethan M Balk
BACKGROUND: Endovenous ablation (EVA) of the great saphenous vein (GSV), with radiofrequency (RFA) or laser ablation (EVLA), has largely replaced the standard ligation and stripping (L&S). Several randomized controlled trials (RCTs) have reported data on efficacy of the ablation with little focus on complications. We analyzed the current literature for short-term complications of EVA as compared with L&S. METHODS: We searched MEDLINE, the Cochrane Central Trials Registry, and individual journals from January 2008 through January 8, 2013 for RCTs comparing RFA and/or EVLA and/or L&S to treat GSV incompetence...
October 2013: Journal of Vascular Surgery. Venous and Lymphatic Disorders
Stephen J Goodyear, Isaac K Nyamekye
SCOPE OF THE REVIEW: This article systematically reviews the practice of radiofrequency ablation of lower limb varicose veins. We present the clinical evidence and best practice techniques for currently available devices. METHODS: Manufacturer's instructions-for-use were requested for all radiofrequency devices. The MEDLINE and EMBASE databases were searched using the following keywords: 'varicose veins' AND 'radiofrequency' OR 'radio frequency' OR 'Venefit' OR 'ClosureFAST' OR 'RFiTT' OR 'EVRF' OR 'VeinCLEAR', generating 240 articles...
November 2015: Phlebology
V Sounderajah, H M Moore, A Thapar, T R A Lane, K Fox, I J Franklin, A H Davies
OBJECTIVE: Cerebrovascular events have been noted after foam sclerotherapy for varicose veins. One hypothesis is migration of microemboli to the brain through a cardiac septal defect. The aim of this study was to identify whether acoustic reflectors are found in the right side of the heart during radiofrequency ablation of varicose veins, as neurological events are not reported during these procedures. METHODS: Transthoracic echocardiography was performed during local anaesthetic radiofrequency ablation (VNUS ClosureFast) of the great saphenous vein in 14 patients...
September 2015: Phlebology
Meghan Dermody, Marlin W Schul, Thomas F O'Donnell
OBJECTIVE: We assessed the incidence of venous thromboembolism following treatment of great saphenous insufficiency by endovenous thermal ablation or foam sclerotherapy using meta-analysis of published randomized controlled trials and case series. METHODS: Medline, Embase, Cochrane, and Clinical Trials Registry databases were searched from January 2000 through January 2013 for randomized controlled trials and large case series employing endovenous thermal ablation or foam sclerotherapy as a single modality for the treatment of great saphenous insufficiency, with concomitant postoperative duplex scanning...
June 2015: Phlebology
John Avery, Keshav Kumar, Vijaya Thakur, Anjani Thakur
Endovascular radiofrequency ablation is a minimally invasive method to safely treat symptomatic refluxing varicose veins. A retrospective chart review was used to determine patient demographics, disease severity, treatment algorithm, and outcome in patients who underwent radiofrequency ablation of symptomatic refluxing veins that had failed conservative management. Statistical analysis was done using GraphPad Demo Version (San Diego, CA). Two hundred forty-one limbs in 179 patients (average age, 53 years; 73% females, 27% males) were treated...
March 2014: American Surgeon
Chad E Jacobs, Maria Mora Pinzon, Jennifer Orozco, Peter J B Hunt, Aksim Rivera, Walter J McCarthy
BACKGROUND: Endovenous radiofrequency ablation (RFA) is a safe and effective treatment for varicose veins caused by saphenous reflux. Deep venous thrombosis (DVT) is a known complication of this procedure. The purpose of this study is to describe the frequency of DVT after RFA and the associated predisposing factors. METHODS: A retrospective analysis was performed using prospectively collected data from December 2008 to December 2011; a total of 277 consecutive office-based RFA procedures were performed at a single institution using the VNUS ClosureFast catheter (VNUS Medical Technologies, San Jose, CA)...
April 2014: Annals of Vascular Surgery
Michael Kendler, Jan C Simon, Tino Wetzig
AIM: To demonstrate the possible use of a tumescent solution containing lidocaine and prilocaine for radiofrequency-assisted segmental thermal ablation and to reduce the need for postoperative analgesics. METHODS: Fifty patients (51 limbs) underwent radiofrequency-assisted segmental thermal ablation (VNUS Closure FAST(™) ) of insufficient great and small saphenous veins and phlebectomy. The amount of tumescent fluid injected was noted, and evaluation of pain reported on visual analog scale (VAS) and quantity of the postoperative analgesics used and their side effects were recorded one day and six weeks after the procedure...
June 2013: International Journal of Dermatology
Joseph Michael R Zuniga, Anil Hingorani, Enrico Ascher, Alexsander Shiferson, Daniel Jung, Robert Jimenez, Natalie Marks, Thomas McIntyre
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...
April 2012: Journal of Vascular Surgery
César García-Madrid, J Oscar Pastor Manrique, Félix Gómez-Blasco, Eusebi Sala Planell
Until recent years, the gold standard for treatment of truncal varicose veins has been high ligation and stripping of the saphenous vein. In the course of the last decade, new minimally invasive techniques based on endothermal ablation are progressively supplanting conventional surgery in the treatment of varicose veins. The endovenous treatment of varicose veins has been developed to reduce complications associated with conventional surgery and to improve quality of life. Radio frequency ablation (RFA) available since 1999 is now established as a safe and efficacious treatment for the ablation of refluxing saphenous veins...
February 2012: Annals of Vascular Surgery
Ian M Nordon, Robert J Hinchliffe, Ranjeet Brar, Paul Moxey, Steve A Black, Matt M Thompson, Ian M Loftus
BACKGROUND: Endovenous ablation of varicose veins using radiofrequency ablation (RFA) and endovenous laser therapy (EVLT) has reported advantages over traditional open surgical treatment. There is little evidence comparing the efficacy and patient-reported outcomes between the 2 endovenous solutions. This study compares the RFA and EVLT strategies in a prospective double-blind clinical trial. METHODS: Consecutive patients with primary unilateral great saphenous vein (GSV) reflux undergoing endovenous treatment were randomized to RFA (VNUS ClosureFAST) or EVLT (810-nm diode laser)...
December 2011: Annals of Surgery
César García-Madrid, Julio Óscar Pastor Manrique, Félix Gómez Blasco, Eusebi Sala Planell
UNLABELLED: Lower limb varicose veins are often secondary to greater saphenous vein (GSV) insufficiency. Technological development has led to the appearance of new minimally invasive treatments, such as endovenous radiofrequency ablation (ERFA). This almost completely eliminates the disadvantages associated with conventional surgery (haematomas, scars, inguinal neovascularisation, and a prolonged time off work). Furthermore, it gives a better quality of life, less pain and inflammation than the endolaser...
August 2011: Cirugía Española
S Sufian, S Lakhanpal, J Marquez
OBJECTIVE: This retrospective study was undertaken to review our experience with ablation of superficial veins with significant reflux, using VNUS ClosureFAST RF (radiofrequency) or laser 980 nm, in patients with primary chronic venous ulcers, and also determine its effects in ulcer healing and ulcer recurrence. METHOD: Included were 25 limbs (18 patients with chronic primary venous ulcers (clinical, aetiological, anatomical and pathological elements [CEAP] classification C6), who underwent endovenous ablation with RF for the axial veins or laser for the perforating veins during a two-year period...
October 2011: Phlebology
V C Ciccarone, J A Jessee, P Liljeström
The SFV Expression System is a DNA expression system used to produce recombinant protein in eukaryotic cells (1,2). The SFV system is based on the Semliki Forest Vnus (SFV), which has several features that provide distinct advantages for a good cDNA expression system. These are: 1. The SFV RNA genome has a positive polarity and thus functions directly as an mRNA. Infectious RNA molecules can be therefore obtained by transcription from a full-length cDNA copy of the genome, 2. The SFV RNA molecule codes for its own RNA rephcase...
1998: Methods in Molecular Medicine
C J Healey, S Read
The hepatitis C virus (HCV) is an orgainsm of the age of molecular biology, for its discovery and much of the research into the infection have relied heavily on molecular techniques. The development of molecular cloning enabled a successful strategy that finally identified HCV (1)as the cause of 90% of posttransfusion (2)and > 50% of sporadic non-A, non-B hepatitis (3) after the failure by immunological techniques to discover the responsible agent. It is an important infection as most infected patients developed chronic hepatitis (> 50%) that can progress to cirrhosis and hepatocellular carcinoma (4-6) ...
1998: Methods in Molecular Medicine
M T Roos, B L S Borger van der Burg, J J Wever
The objective of the study was first to quantify the level of pain that patients experience during VNUS ClosureFAST™ and in the first week following treatment. Secondly, to investigate the use of pain medication. Thirdly, to identify after how many days patients return to daily activities and whether pain is a factor of influence. A prospective descriptive cohort study was carried out. In all, 104 consecutive VNUS ClosureFAST procedures for greater saphenous vein (GSV) incompetence between 18 May and 28 August 2009 in the HagaZiekenhuis were included...
August 2011: Phlebology
M Perrin
Endovenous treatment is progressively supplanting open surgery in treatment of saphenous reflux. Among the emerging techniques the VNUS Closure, procedure with ClosureFast is one of the most promising. The aim of the presente review is to remind the principle of radiofrequency action in varicose vein treatment, to describe the procedure achievement including the devices used generator and catheter and finally to report the published studies on ClosureFast. A research in the published literature identified only two articles reporting the outcome of procedure...
August 2010: International Angiology: a Journal of the International Union of Angiology
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