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ClosureFast™ RFA System (Radiofrequency Ablation)
ClosureFast™ RFA System is a minimally invasive or key hole technique for the treatment of Superficial Venous Reflux and Varicose Vein Removal. The procedure is performed under local anaesthetic as a “walk in, walk out” procedure without the need to be admitted to a hospital. Using Radiofrequency energy, the vein is heated from the inside to a temperature at which the vein closes and is cauterised. All the living cells that make up the vein wall are sterilised and the vein cannot recover, regrow and rejoin. Over the course of a few weeks the body then naturally absorbs the vein. Microscopic cells such as white cells and macrophages autodigest the vein and carry it away. When the treated area is examined with ultrasound a few months after treatment, the abnormal vein has gone.
ClosureFast™ achieves the same outcome as surgical tying and stripping but without the need for major surgical cuts and painful removal under general anaesthetic. ClosureFast™ can be carried out in a simple treatment room rather than an operating theatre.
In addition, after ClosureFast™, unlike surgical stripping there are no “raw ends of living vein” that can regrow or rejoin. The risks of veins coming back after ClosureFast™ is much lower than with surgery.
Benefits of the ClosureFast™ RFA System
- Relief of symptoms
- A walk in, walk out, day case procedure
- Minimal discomfort afterwards
- Resumption of Activities usually within 2-3 days
- Excellent cosmetic outcome with minimal or no scarring
- Minimal or no time off work
- Very rapid results
ClosureFast™ RFA Procedure
Stages of the ClosureFast™ RFA System
Mapping of the Saphenous Vein
The procedure begins with ultrasound imaging of the refluxing vein to trace its location. This allows the specialist to determine the site where the Closure catheter will be inserted and to mark the desired position of the catheter tip to begin treatment.
Insertion of the Closure Catheter
Under ultrasound control the Closure catheter is inserted into the vein and advanced to the uppermost segment of the vein. The specialist then injects a volume of dilute anaesthetic fluid into the area surrounding the vein. This numbs the leg, helps squeeze blood out of the vein, and provides a fluid layer outside the vein to protect surrounding tissue from heat once the catheter starts delivering radio-frequency energy.
Delivery of RadioFrequency Energy and Withdrawal of Catheter
Non-invasive ultrasound is used to confirm the catheter tip position and the specialist then activates the generator, causing the electrodes at the tip of the catheter to heat the vein wall to a target temperature of 120 degrees Centigrade. As the vein wall is heated, the vein shrinks and the catheter is gradually withdrawn. As the catheter is withdrawn, the generator regularly adjusts the power level to maintain target temperature to effectively shrink collagen in the vein wall and close the vein completely.
Confirmation of Vein Closure
After treatment, ultrasound imaging is used to confirm closing of the vein. If a portion of the vein is not closed, the catheter can be reinserted and energy reapplied. After the procedure, the narrowed vein gradually becomes fibrous, sealing the interior of the vein walls and naturally redirecting blood flow to healthy veins. The procedure is completed in 45 to 60 minutes.
What is the difference between Endovenous Laser Ablation (EVLA) and ClosureFast™RFA System?
Different clinics and different specialists prefer using either ClosureFast™ or ELVA. The medical literature indicates that both methods of endothermal ablation are effective with excellent safety profiles. Both methods of treating superficial venous reflux are recommended by the National Institute for Health and Care Excellence in its guidance CG168.
Both ClosureFast™ and EVLA are methods of closing and cauterising unhealthy veins using heat energy delivered directly inside the vein. In this respect, they are both classified as methods of endothermal ablation. Miss McGuinness and Dr Gajraj currently use EVLA routinely. We believe that using one method preferentially offers some advantages:
- All members of the team frequently use one piece of equipment and therefore everyone is familiar with its operation
- The procedure is performed frequently and everyone understands the steps involved and their roles in its performance
- Stock control, servicing, maintenance and calibration is less complicated and time consuming when using one system rather than two
Bottom line: from the patient’s perspective, there is no major difference between EVLA and ClosureFast™ except that patients being treated by EVLA will need to wear protective safety goggles while the laser equipment is active.