• SCVS Home
• President's Message
• Council
• Commitees
• Annual Meeting
• 37th Annual Symposium
• 36th Annual Symposium
• 35th Annual Symposium
• 34th Annual Symposium
• 33rd Annual Symposium
• Membership
• Join SCVS
• Members Only Area
• Find a Vascular Specialist
• Newsletters
• Journal
• History
• Mission Statement
• Bylaws
• Contact Us
• 37th Annual Symposium
• 36th Annual Symposium
• 35th Annual Symposium
• 34th Annual Symposium
• 33rd Annual Symposium
• Join SCVS
• Members Only Area
• Find a Vascular Specialist

Radiofrequency ablation of greater saphenous vein using the ClosureFAST catheter is associated with higher risk of DVT compared to the first generation closure catheter

Introduction: New endovenous ablation technologies, using laser or radiofrequency (RFA) ablation, have replaced vein stripping for the treatment of superficial venous reflex and varicose veins. Minimal invasive treatments were adopted to minimize the postoperative morbidity seen with vein stripping. However, we report our data using the new ClosureFAST catheter during RFA and risk of deep venous thrombosis (DVT).
Methods: We did a retrospective review of our data on RFA of greater saphenous vein (GSV) using the V-NUS closure device at a single institution, The Methodist DeBakey Hospital, Houston, Texas. We started using this technology in November 2002 and performed roughly 375 procedures on 250 patients using the Closure catheter. Since January 31^st 2007, we performed roughly 69 procedures on 46 patients using the new ClosureFAST catheter. The new catheter utilizes a temperature of 120 °C to ablate the vein in a shorter time compared to the first generation catheter. All these patients were evaluated postoperatively for DVT by venous Duplex.
Results: In the first 375 cases we encountered 5 cases of DVT. Since using the closureFAST, we encountered 6 cases of DVT in 69 cases. In most of these cases, the duplex shows a partial thrombus extending from the sapheno-femoral junction into the common femoral vein. All of the DVT patients were anticoagulated and none had any clinical evidence of pulmonary embolus. The incidence of increased DVT with the closureFASTcatheter is not well known. The higher temperature needed to ablate the vein, inability to visualize the tip as compared to the older catheter, variation of the tip position with leg positioning, compressing the catheter forward while pushing down on the catheter during ablation are potential explanations.
Conclusion: This report is to alert the physicians utilizing this new technology to be very vigilant when using this new closureFAST catheter, specially when it comes to catheter tip positioning. We recommend placing the tip at least 2 cm distal to the saphenofemoral junction.