Endovenous ablation of incompetent truncal veins and their perforators with a new radiofrequency system. Mid-term outcomes

Spiliοpoulos, Stavros; Theodosiadou, Vasiliki; Sotiriadi, Athanasia; Karnabatidis, Dimitrios

doi:10.1177/1708538114564462

Cited by 21 publications

(20 citation statements)

References 27 publications

(39 reference statements)

Supporting

Mentioning

Contrasting

Order By: Relevance

“…The radiofrequency energy was applied along the fistula tract while removing an endovascular flexible probe (radially emitting) from the internal to the external orifice. This strategy is derived from endovascular procedures for varices . Energy was delivered every 5 mm with an endovenous radiofrequency source (EVRF®; F Care Systems, Antwerpen, Belgium).…”

Section: Methodsmentioning

confidence: 99%

See 1 more Smart Citation

Sphincter‐sparing surgery for complex anal fistulas: radiofrequency thermocoagulation of the tract is of no help

et al. 2019

View full text Add to dashboard Cite

Aim To compare the rate of failure of radiofrequency thermocoagulation for anal fistula with that of rectal advancement flap in a case‐matched study. Method Patients who underwent radiofrequency treatment were compared with age‐ and sex‐matched patients with Crohn's disease (CD) who underwent a rectal flap procedure. Fistula features, general characteristics and the main clinical events were recorded in a prospective database. Failure was defined by at least one of following: abscess, purulent discharge, visible external opening or further drainage procedure. Results A total of 62 patients [median age 45 (range 36.8–57.5) years; 22 women, 40 men; 22 with CD] were analysed. The failure rate of radiofrequency treatment was higher than that of rectal flap treatment (74.2% vs 32.2%; P = 0.004). The cumulative probabilities of failure of the radiofrequency treatment were 53.8% (38.8–68.3), 71.8% (55.3–84.0) and 87.4% (70.6–95.3) at 3, 6 and 12 months, respectively. Three patients in the radiofrequency group required drainage for an abscess and one had severe thermal ulceration. The Cox proportional hazards regression model (surgical procedure, obesity, CD) showed rectal flap treatment [3.48 (1.60–8.07); P = 0.001] and CD [2.60 (1.16–6.41); P = 0.02] to be the main independent predictors of healing. Conclusion Radiofrequency thermocoagulation is a less satisfactory sphincter‐sparing treatment for the management of anal fistula than a rectal flap procedure.

show abstract

Section: Methodsmentioning

confidence: 99%

“…Other approaches attempt to achieve coagulation or closure of the fistulous tract through heat destruction, occlusion or ligation . However, these new methods are mainly case series without any comparative evaluation .…”

Section: Introductionmentioning

confidence: 99%

Sphincter‐sparing surgery for complex anal fistulas: radiofrequency thermocoagulation of the tract is of no help

et al. 2019

View full text Add to dashboard Cite

show abstract

“…13 The only publication on effectiveness of EVRF showed modest ablation rates of 89.2% at one year; however, complication rates were low. 14 These three radiofrequency devices were directly compared in a randomised controlled trial.…”

Section: Introductionmentioning

confidence: 99%

A Randomised Controlled Trial Comparing Three Different Radiofrequency Technologies: Short-Term Results of the 3-RF Trial

Nyamekye

Dattani

Hayes

et al. 2019

European Journal of Vascular and Endovascular Surgery

View full text Add to dashboard Cite

This paper demonstrates a clear difference between radiofrequency thermal ablation outcomes, with endovenous radiofrequency (EVRF) having significantly greater early failures (6 months) than Venefit and radiofrequency induced thermal therapy (RFITT). The paper also demonstrates the safety of the routine practice of starting ablation within 5 mm of the saphenofemoral junction (SFJ). The commonly cited (but little evidenced) ! 2 cm clearance from the SFJ is not backed by research studies and exposes patients to long-term risk of recurrence from junctional tributaries. It is hoped that this paper will stimulate research directed at this aspect of thermal ablation treatment. Objective: To date there has been no comparison of outcomes of endovenous radiofrequency (RF) devices. The 3-RF trial is the first randomised controlled trial of three commercially available RF ablation technologies. Methods: Patients were recruited [182/302 patients with great saphenous vein (GSV) incompetence] into a prospective double blind randomised trial of Venefit, radiofrequency induced thermal therapy (RFITT), and endovenous radiofrequency (EVRF). The primary outcome measure was GSV closure (total/partial/failed) at six months. Secondary outcome measures included ablation times, complications, pain scores, analgesia requirements, and quality of life (QoL) scores to 12 months. Results: Patients treated [180: Venefit (57), RFITT (64), EVRF (59)] were matched for age, sex, and vein characteristics. At six months, complete GSV closure was significantly better after Venefit and RFITT treatment (100% and 98%, respectively) compared with EVRF treatment (79%, p < .001). Mean treatment time was significantly faster for RFITT than for Venefit and EVRF (p < .0001). Euroqol 5D (EQ5D) visual analogue score (VAS) did not differ between groups at any time point. The only difference between groups in EQ5D domain scores was for the pain/discomfort domain at two weeks when significantly fewer EVRF patients reported no problems compared with Venefit and RFITT. This difference had disappeared at six and 12 months. The Aberdeen Varicose Vein Questionnaire (AVVQ) improved for all groups at six and 12 months compared with pre-treatment levels; however, there was no significant difference between groups. Conclusion: Compared with Venefit and RFITT, EVRF was associated with significant failure of truncal ablation at six months; however, clinical outcomes did not differ significantly at 12 months. clinicaltrials.gov identifier:

show abstract

“…There is only one publication describing the efficacy and outcomes of EVRF so far: A total of 74 limbs was treated so far, yielding 96 % occlusion after one month and 89 % at one year with low complication rates (37). Because EVRF is utilized as a monopolar RF device, its utilization treating patients with cardiac pacemakers and/ or defibrillator implants is absolutely contraindicated (38).…”

Section: Resultsmentioning

confidence: 99%

Radiofrequency ablation of varicose veins

Tesmann¹

2017

Phlebologie

View full text Add to dashboard Cite

SummaryBackground: In the search of alternative techniques to high ligation and stripping (HL/S) in the treatment of varicose veins, catheter-ablation methods have been implemented since 1998. Besides endovenous laser techniques (ELT) radiofrequency ablation (RFA) is a successful device in treating insufficiency of the Great (GSV) and Small saphenous vein (SSV). Methods: This review article sums up publications on Closure Plus™, ClosureFAST™, RFITT® (Celon Method), and EVRF®. It discusses the actually favorized treatment protocols and study results. Results of meta-analysis are presented, too.Results: The Closure Plus™ catheter was the first radiofrequency technique to be licensed in Europe in 1998. Trials and meta-analyzes show occlusion rates of 81–89 % after 5 years. The consecutive technique was the ClosureFAST™ (CLF) catheter that was introduced in 2007 and offered more standardization in treatment. Published data show occlusion rates of 98 % after 5 years and low profile on complications. Also in 2007 a bipolar radiofrequency technique called RFITT was presented. Due to lack of standards in treatment protocol it could not get accepted as well as CLF despite of good treatment results (92–98 % occlusion rates after 12 months) and low complications. A new RFA device called EVRF® shows weak evidence so far.Conclusion: Radiofrequency ablation of varicose veins has become a well-established treatment alternative to HL/S mostly represented by CLF.

show abstract

Endovenous ablation of incompetent truncal veins and their perforators with a new radiofrequency system. Mid-term outcomes

Cited by 21 publications

References 27 publications

Sphincter‐sparing surgery for complex anal fistulas: radiofrequency thermocoagulation of the tract is of no help

Sphincter‐sparing surgery for complex anal fistulas: radiofrequency thermocoagulation of the tract is of no help

A Randomised Controlled Trial Comparing Three Different Radiofrequency Technologies: Short-Term Results of the 3-RF Trial

Radiofrequency ablation of varicose veins

Contact Info

Product

Resources

About