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Experience with radiofrequency closure of varicose veins (VNUS)

Objective: The aim of this study was to reproduce the results of VNUS closure in our setting; to minimize the cost associated with the procedure; and to reduce the need for an experienced ultrasonographer during the procedure. Methods: Over a two-year period, 26 patients (42 limbs) were treated. A VNUS radio-frequency machine was used and assisted by intraoperative localization using Sonosite ultrasound, which was operated by the surgeon. All patients were treated under general anaesthetic. Nine patients were operated as a day case and 17 others stayed overnight. Median follow-up period was seven months. Results: The mean age of the patients was 37 years (range 19–69). Eighteen patients had primary and eight had recurrent varicose veins. Sixteen patients underwent bilateral and 10 underwent the unilateral procedure. Long saphenous vein (LSV) closure was performed in 41 limbs and short saphenous vein closure in two limbs. The LSV was accessed at the ankle in 36 and at knee in three limbs. In two other limbs, groin exploration with retrograde closure of the LSV was achieved. One patient developed numbness at phlebectomy site. None of the patients had deep vein thrombosis and all the treated veins were closed at the one-week scan. In bilateral cases, one catheter was used instead of two for closure in 12 of the 16 limbs. Using our approach, we were able to make a cost savings of £8,600.00. Conclusion: Technical success in radiofrequency vein closure can be achieved without the need for an additional ultrasonographer. We have shown that our approach is safe, effective and less expensive to deliver.