The endovenous RFITT-treatment of varicose veins, a new method of interventional phlebology

Abstract

SummaryEndovenous bipolar RFITT (RadioFrequency-Induced ThermoTherapy) is a new approach for the treatment of chronic venous insufficiency. During treatment with RFITT (also known as the Celon method) a thermal effect on the vein walls is applied thanks to bipolar energy delivery. An alternating high frequency current creates heat in the vessel enabling a controlled tissue shrinkage. A continuous impedance measurement allows the controlled heat exposure on the vein wall. An acoustic signal guides the physician during the RFITT application. The Celon power control unit turns off automatically when the desired treatment result is achieved. Patients, method: In our clinic we have used the Celon method from October 9, 2007 through October 10, 2008 for the treatment of 331 varicose veins in 199 patients. 78% of these treatments were applied in the Vena saphena magna (VSM) whereas 22% concerned the Vena saphena parva (VSP). We have treated more than one large varicose vein simultaneously in 117 cases. In 31 varicose veins, which had been treated with laser and became recurrent again, we applied RFITT and were able to occlude the vein permanently. Results: In our patient population we achieved an occlusion rate of 97.6% at 12 months follow up. Five cases in the VSM and three cases in the VSP were recurrencies. We think that this – following to the guidance of the company – was caused by pulling back the RFITT applicator too fast in the vein (application time: 1.2–1.5 s/cm) and with an excessive energy amount of 20–22 W. Meanwhile, we have adapted our technique to a slower mode (18 W, application time 3.4 s/cm) and are achieving significantly better results. Conclusion: We are convinced that we have now found the optimal energy amount and pull-back speed.