CASE REPORT   

Acta Phlebologica 2018 April;19(1):33-6

DOI: 10.23736/S1593-232X.18.00411-3

Copyright © 2018 EDIZIONI MINERVA MEDICA

language: English

Application of radiofrequency in unusual clinical circumstances

Wassila TAHA ✉, Rashad BISHARA

Vein Clinics of Egypt, Cairo, Egypt

Radiofrequency ablation (RFA) is minimally invasive endovenous technique for ablation of the incompetent great saphenous vein (GSV). We have performed this procedure in two different unusual clinical conditions. The first case was a young female patient suffering from pulmonary emboli (PE). By duplex, there was no deep venous thrombosis, only distal GSV thrombosis. Her clinical condition was worsening, despite receiving full anticoagulation treatment. RFA of proximal GSV was performed to discontinue the pathway of pulmonary emboli originating from thrombosis of the distal GSV; using ClosureFast VNUS device, the procedure was uneventful. In the second case, RFA was the procedure of choice to ablate GSV as well as anterior accessory saphenous vein (AASV), both trunks detected, by the duplex, dilated and refluxing. AASV lining in the fascial compartment and was differentiated from the GSV being aligned with femoral vessels, superficial femoral artery (SFA) and the femoral vein (FV). Both trunks were obliterated using same device as in the first case (ClosureFast VNUS). In the first case, GSV occlusion was confirmed by duplex, with significant improvement of patient clinical condition; in the second case, both GSV and AASV were completely obliterated by duplex. Duplex follow-up scans of these two patients performed, showed complete obliteration of the ablated trunks, with no significant complication. In conclusion, RFA is a safe procedure, it can be applied in uncommon clinical conditions; to ablate proximal course of embolizing distal thrombosed GSV, and to ablate more than one trunk in the same session, successfully.

KEY WORDS: Pulsed radiofrequency treatment - Catheter ablation - Thrombosis - Saphenous vein