1. What is CLosureFast™ Targeted Endovenous Therapy?
The CLosureFast™ procedure is a minimally invasive treatment that uses radiofrequency (RF) energy to effectively treat patients suffering from varicose veins or Chronic Venous Insufficiency (CVI). A vein specialist inserts a catheter into a diseased vein to provide consistent and uniform heat to contract the collagen in the vein walls, causing them to collapse and close. After the vein is sealed shut, blood is then naturally redirected to healthy veins.
The 2009 RECOVERY Study confirms that patients experience less bruising and pain, and fewer complications with the Covidien ClosureFast™ Endovenous Radiofrequency Ablation (RFA) Catheter in comparison to 980 nm laser ablation.
The ClosureFast™ procedure also results in little to no scarring and is generally performed using local anesthesia in our office.
2. What is Chronic Venous Insufficiency (CVI)?
CVI is a progressive medical condition in which the valves that carry blood from the legs to the heart no longer function, causing blood to pool in the legs and veins to swell. This incorrect blood flow (or reflux) causes veins to expand, lose form and protrude from beneath the skin. Common symptoms include pain, leg swelling, leg heaviness and fatigue as well as skin changes and ulcers in more severe cases.
Varicose veins are often thick, bulging veins that can protrude well beyond the skin’s surface.
3. How do you treat varicose veins and CVI?
Since the valves in the legs cannot be repaired, the only alternative is to re-route blood flow from the diseased veins to healthy veins. Traditionally, this has been done by surgically removing (stripping) the troublesome vein from your leg. The CLosureFast™ and VenaSeal™ procedures, however, provide less invasive alternatives to vein stripping by simply closing the diseased vein. Once the diseased vein is closed, it becomes scar tissue and is eventually absorbed by the body.
4. How is the CLosureFast™ procedure different from vein stripping?
Vein stripping is a surgical procedure, where the surgeon makes an incision in your groin and ties off the vein, after which a "stripper" tool is threaded through the leg vein in order to pull it out through a second incision just above the calf.
The ClosureFast™ procedure is minimally invasive. In contrast to vein stripping, the vein remains in place and is closed using a special catheter inserted through a small puncture below the knee.
Vein stripping is usually performed in an operating room under a general anesthetic, while the Venefit procedure is performed on an outpatient basis, typically using local anesthesia in our office.
5. How is the ClosureFast™ procedure different from the laser ablation treatment?
The ClosureFast™ procedure utilizes radiofrequency energy to provide consistent and controlled heat to contract the collagen in the vein walls, causing them to gently collapse and seal. Once a leg vein is closed, blood flow is redirected to healthy veins.
Laser ablation, on the other hand, uses laser heat to collapse and seal the affected vein. The laser targets the blood in the vein, which causes the blood to boil. This heat creates a steam bubble inside the vein, creating damage to the vein so that the vein collapses. Unlike the CLosureFast™ procedure, laser temperatures can reach over 700 °C.
6. How long does the ClosureFast™ procedure take?
The CLosureFast™ procedure takes approximately 30-45 minutes, although patients may normally spend 2-3 hours at the office due to normal pre- and post-treatment procedures.
7. Is the ClosureFast™ procedure painful?
Most patients report feeling little, if any, pain during the procedure. Our physician’s will give you a local anesthetic to numb the treatment area.
8. Does it require anesthesia?
Our office uses a combination of oral and local anesthesia for pain control and sedation during the procedure.
9. How quickly after treatment can I return to normal activities?
Many patients experience a quicker return to normal activities. For a one week to ten days following the treatment, we may recommend a regular walking regimen and suggest you refrain from very strenuous activities (heavy lifting, for example) or prolonged periods of standing.
10. How soon after treatment will my symptoms improve?
Most patients report a noticeable improvement in their symptoms within one to two weeks following the procedure. Some patients report immediate improvement.
11. Is there any scarring, bruising or swelling after the ClosureFast™ procedure?
Patients report minimal to no scarring, bruising or swelling following the ClosureFast™ procedure.
12. What potential risks and complications are associated with the ClosureFast™ procedure?
As with any medical intervention, potential risks and complications exist with the ClosureFast™ procedure. All patients should consult their vein specialist to determine if their conditions present any special risks. Your vein specialist will review potential complications of the ClosureFast™ procedure at the consultation, which can include vessel perforation, thrombosis, pulmonary embolism, phlebitis, hematoma, infection, paresthesia (numbness or tingling) and/or skin burn.
13. Is the ClosureFast™ procedure suitable for everyone?
Only a vein specialist can tell you if the ClosureFast™ procedure is the right option for your vein problem. Experience has shown that many patients with CVI can be treated with the ClosureFast™ procedure.
14. Is age an important consideration for the ClosureFast™ procedure?
The most important step in determining whether or not the ClosureFast™ procedure is appropriate for you is a complete ultrasound examination by your vein specialist. Age alone is not a factor in determining whether or not the ClosureFast™ procedure is appropriate for you. The ClosureFast™ procedure has been used to treat both women and men across a wide range of ages.
15. How effective is the ClosureFast™ procedure?
The ClosureFast™ procedure has been shown in a large international, multi-center study to be 93% effective over three years.
16. What happens to the treated vein left behind in the leg?
The vein simply becomes fibrous tissue after treatment. Over time, the vein will gradually be completely absorbed into surrounding tissue.
17. Is the ClosureFast™ procedure covered by my insurance?
Many insurance companies pay for the ClosureFast™ procedure in part or in full. The ClosureFast™ procedure has coverage policies with major health insurers. Our office staff can discuss your insurance coverage further at the time of consultation.
18. How long do I have to wear compression stockings?
Following the procedure our staff wraps your leg in a special dressing and then places a thigh high compression stocking on your leg. We advise that this remain on for 48 hours without being removed. When the 48 hours is complete you may remove the stocking and wrap, shower, and replace the compression stocking. We advise that you wear a thigh high compression stocking of 20-30mmHg, during waking hours, for 6 weeks following the procedure.
19. Will I need to miss work?
We typically perform the procedure on a Friday and patients are usually able to return to work on Monday. You will not be able to report to work the day of the procedure.
20. Can I drive myself to the procedure?
No, you will need a driver. We will be administering a mild sedative prior to the procedure and you will not be able to drive the day of the procedure.
21. What should I bring the day of the procedure?
You will need to bring your compression stockings, loose fitting shorts or pants, and any medications we may have prescribed for the procedure.
22. Can I take my medications the morning of the procedure?
Yes, we encourage you to take any scheduled medications the morning of your procedure. Should you be on anticoagulant medications (such as Coumadin or Xarelto) we may ask you to hold these medications, however, most medications are safe to take.
23. Am I allowed to eat the day of the procedure?
Yes, however, we ask that you do not eat a heavy meal prior to arriving at our office. A light breakfast is acceptable. We also ask that you drink extra water so you are nice and hydrated.
1. Almeida JI, Kaufman J, Göckeritz O, et al. Radiofrequency endovenous ClosureFast versus laser ablation for the treatment of great saphenous reflux: a multicenter, single-blinded, randomized study (RECOVERY Study). J Vasc Interv Radiol. 2009;20:752-759.
2. L. H. Rasmussen, M. Lawaetz, L. Bjoern, B. Vennits, A. Blemings and B. Eklof, Randomized Clinical Trial Comparing Endovenous Laser Ablation, Radiofrequency Ablation, Foam Sclerotherapy and Surgical Stripping for Great Saphenous Varicose Veins. British Journal of Surgery Society Ltd., Wiley Online Library, www.bjs.co.uk, March 15, 2011.
3. Dietzek A. Current data on radiofrequency ablation with the ClosureFast catheter. Presented at the 37th Annual Veith Symposium; November 17, 2010; New York.
4. Weiss RA, Weiss MA. Controlled radiofrequency endovenous occlusion using a unique radiofrequency catheter under duplex guidance to eliminate saphenous varicose vein reflux: A 2-year follow-up. Dermatol Surg 2002;28:38-42.
5. Proebstle T, et al. Three-year European follow-up of endovenous radiofrequency-powered segmental thermal ablation of the great saphenous vein with or without treatment of calf varicosities. JVS; July 2011.