Clinical utility of the Covidien Closure Fast™ Endovenous Radiofrequency Ablation Catheter

Abstract

The Closure Fast™ Endovenous Radiofrequency Ablation Catheter is the latest version of a minimally invasive system for the treatment of patients with superficial venous disease. The Closure Fast™ catheter heats the vein wall to 120°C, causing denaturation of the collagen of the vein wall and contraction of the vessel such that no blood can flow through it. Nearly one million systems have been sold since the product was launched. Many, if not all, patients can be treated under local anesthesia with the Closure Fast™ catheter. Duplex ultrasound reports occlusion rates for the treated vein of 94%–98% at 1 year and 85%–93% at 3 years. The system produces average postoperative pain scores of less than 2 out of 10 on a visual analog score. In the first postoperative week, 76% of patients do not require analgesia. Some 45% of patients return to normal activity on the first postoperative day. Serious complications appear to be rare following the Closure Fast™ procedure. Transient paresthesia occurs in 0.2% of cases, thrombophlebitis in 1%–10%, and thromboembolic events in up to 1.4%, mainly heat-induced thrombosis. Closure Fast™ adds significant costs to treating superficial venous disease but studies have shown it to be cost-effective when used in an office setting.

Three-year follow-up and quality of life of endovenous radiofrequency ablation of the great saphenous vein with the ClosureFast™ procedure: Influence of BMI and CEAP class

“…15 As the tissue heats up, it warms the tip of the catheter, which in turn reduces the RF flow and avoids overheating of the tissue. 16 In this way, the catheter eliminate the need for continuous pull-back of the energy source as in the case of laser ablation allowing for more controlled and repeatable RFA and consistent, reproducible delivery of energy.…”

Chronic Venous Disorders: A Contemporary Review

“…With ClosureFast ™ Endovenous Radiofrequency Ablation Catheter (Medtronic, Inc.; Minneapolis, Minn), occlusion rates of 100% at 1 week, 97% to 99.7% at 3 months, 95% to 98% at 1 year, and 85% to 93% at 3 years have been reported. 11,12 Longer term benefit has also been demonstrated in five-year follow-up data that revealed a shift from CEAP class C2 to class C1 after ablation. Risks and complications of all these procedures include perforation, deep vein thrombosis, pulmonary embolism, phlebitis, hematoma, infection, skin burns, and nerve injury.…”

Short-Term Results of Radiofrequency Thermal Ablation Using VENISTARⓇ in Treatment of Varicose Veins

“…In 2007, the second-generation radiofrequency thermal ablation device, ClosureFast Ⓡ (with the benefits of segmental ablation and high temperature that overcame the limitations of the first generation radiofrequency thermal ablation device) was introduced, competing with laser ablation devices. ClosureFast Ⓡ has a bipolar catheter and is coated with a positive temperature coefficient of resistance (PTCR) to maintain a constant temperature of 120℃ (6). This allows transmission of conductive heat with a constant temperature of 120℃ to the target vein wall.…”