Update on endovenous radio-frequency closure ablation of varicose veins.

Until recent years, the gold standard for treatment of truncal varicose veins has been high ligation and stripping of the saphenous vein. In the course of the last decade, new minimally invasive techniques based on endothermal ablation are progressively supplanting conventional surgery in the treatment of varicose veins. The endovenous treatment of varicose veins has been developed to reduce complications associated with conventional surgery and to improve quality of life. Radio frequency ablation (RFA) available since 1999 is now established as a safe and efficacious treatment for the ablation of refluxing saphenous veins. Among the emerging therapies, RFA with VNUS ClosureFAST is promising because it has eliminated almost all disadvantages associated with conventional surgery by “stripping” (bruises, scars, ecchymosis, inguinal recurrence, neovascularization, and mainly, prolonged incapacity) with an immediate occlusion rate close to 100%. When it is compared with endovenous laser ablation, RFA technology is associated with less postprocedural pain, less ecchymosis and tenderness, and better quality of life (QOL) measures. The aim of this article is to summarize the available evidence in the RFA treatment of varicose veins.