CARDIOVASCULAR JOURNAL OF AFRICA • Vol 24, No 8, September 2013
AFRICA
317
extended up to 23 mm in both groups. Considering our results,
we can claim that tumescentless RFA using a local compression
and hypothermia technique was as succesful as RFA using
tumescent anaesthesia for GSV diameters exceeding 12 mm.
Deep-vein thrombosis after varicose vein surgery is a well-
known risk.
27
With the development of special endoluminal
catheters, a potential complication of the new techniques was
reported: endovenous heat-induced thrombosis (EHIT).
28
This
can briefly be described as a thrombus extending from the
superficial venous system to the deep venous system.
In our technique, we externally compress the SFJ with the
Doppler probe in order to prevent extension of the thrombus.
Marsh
et al
. performed RFA on 2 470 limbs and identified deep-
vein thrombosis (DVT) in 17 limbs (0.7%).
27
Of these, four were
EHIT. Neither EHIT nor DVT was seen in our study, possibly
due to keeping the tip of the catheter 2 cm distal to the SFJ and
avoidance of the propagation of thrombus by compression of
the SFJ.
Conclusion
Eliminating tumescent infusion is a desirable goal. Tumescentless
endovenous RFA with a local hypothermia and compression
technique appears to be safe and efficacious. Our technique
shortens the operating time and prevents patient procedural
discomfort.
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