CARDIOVASCULAR JOURNAL OF AFRICA • Vol 24, No 7, August 2013
e2
AFRICA
A saphenous vein segment of 38 cm was ablated by applying
40-Watt power on each centimetre using a radiofrequency
ablation catheter (ClosureFast
®
). Each 7-cm saphenous segment
was ablated twice.
Following the procedure, it was confirmed that the patient’s
great saphenous vein was obliterated and that no flow was seen
on colour Doppler ultrasonography. The patient was then sent to
the ward with no complications. Mobilisation was done in the
clinic and the tight bandages were removed four hours later. The
patient wore class 2 (32 mmHg) compression pantyhose until
the next evening.
On the third day postoperatively, on continuous-wave Doppler
and duplex scanning ultrasonography, the great saphenous vein
segment was seen to be obliterated and no flow was seen. The
patient had no pain or sensations of heaviness in his legs on the
tenth day postoperatively, and the first, third and sixth months
of check up.
Discussion
Standard venous surgery may lead to unwanted outcomes such as
continued pain in elderly patients. In a study by Weinmann
et al
.,
pain and swelling in the extremities following standard surgery
was observed at a rate of 89% in a group of patients (mean age
79 years). Complete recovery of patients was delayed up to about
eight weeks and ulcers recurred in some patients.
3
Conclusion
Endovenous ablation is a procedure that increases the quality of
life and comfort of elderly patients, with minimal pain, and they
can return to active life immediately. Radiofrequency ablation
procedures have proved to be more successful in patients of all
age groups than procedures such as standard surgery and foam
therapy.
4
References
1.
O’Hare JL, Earnshaw JJ. Practical advice for the treatment of venous
disease in the elderly.
Phlebology
2008;
23
: 101–102.
2.
Hansson C. Optimal treatment of venous (stasis) ulcers in elderly
patients.
Drugs Aging
1994;
5
(5): 323–334.
3.
Weinmann EE, Poluksht N, Chayen D, Bass A. Surgery of the superfi-
cial venous system in elderly patients.
Vasc Endovascular Surg
2003;
37
(2): 111–115.
4.
Rasmussen LH, Lawaetz M, Bjoern L, Vennits B, Blemings A, Eklof B.
Randomized clinical trial comparing endovenous laser ablation, radi-
ofrequency ablation, foam sclerotherapy and surgical stripping for great
saphenous varicose veins.
Br J Surg
2011;
98
(8): 1079–1087.
