Update on radiofrequency ablation.

The two currently available methods to achieve ablation of incompetent veins using radiofrequency energy are radiofrequency ablation (VNUS Closure Plus(tm)) and radiofrequency powered segmental ablation (VNUS Closure Fast(tm)). Both treatment modalities expose vascular endothelium to high-frequency alternating current. This results in contraction of venous wall collagen with subsequent fibrotic endoluminal obliteration which eliminates hydrostatic and hydrodynamic pressures as the main hemodynamic mechanisms for varicosities. Radiofrequency segmental ablation has become available relatively recently, but increasing amount of clinical data and patient's satisfaction support this technique as a reasonable therapy for superficial reflux disease. Although initial experience with Closure Fasttm catheter documented substantially decreased average procedural time, little postoperative discomfort and short-term occlusion rates that approximated 100%, larger clinical trials are needed before this modification of traditional radiofrequency ablation can be accurately evaluated in the treatment of superficial reflux disease.