SEGMENTAL RADIOFREQUENCY AND ENDOVENOUS LASER.

The treatment of the saphenous trunks (greater, lesser or accessory saphenous vein), using Segmental Radiofrequency (called Closure Fast in English) or endovenous laser, are modern treatments that have revolutionized the therapy for venous insufficiency in recent years.

The technique for performing these procedures is highly standardized. It is a minimally invasive endovenous technique, without open surgery and is performed under local anesthesia and tumescent anesthesia under ultrasound control throughout the procedure (without spinal, epidural or general anesthesia). It allows the majority of patients with varicose veins to be treated in this way, regardless of their caliber and even when there are complications such as ulcers or trophic disorders in the skin of the leg.

The technique is performed using an ultrasound-guided puncture or a mini-incision through which a catheter is inserted inside the trunk of the saphenous vein, along the entire length of the affected segment. Once it is placed, the vein is occluded by thermal discharges carried out on venous segments every 7 cm in the case of RF, or by withdrawing the laser fiber in a controlled manner for a time previously stipulated according to the calculations made by the surgeon depending on the type of laser and the size of the vein. This will lead to a subsequent process of fibrosis (invisible scar) of the affected trunk.

This is the main difference and the greatest benefit of Radiofrequency (Closure Fast) compared to the endovenous laser technique, since the latter needs to adjust the dose of energy by the surgeon and control the removal of the laser fiber at all times. In addition, the laser produces high temperatures that can generate phlebitis and bruising more frequently, which means that Radiofrequency has a better quality of life in the immediate postoperative period and during the first month after the procedure, since it has an automatic system that releases just enough energy to heat the vein just enough, with a much lower risk of damage to the surrounding tissues. In other words, the energy parameters are automatically adapted to the caliber of all the segments of the treated vein.

The treatment of collateral varicose veins, as when dealing with other endovenous techniques, is complemented at the same time and operating time, with a microincision phlebectomy or with foam sclerosis depending on the type of varicose vein, always looking for the best combination between clinical and cosmetic result.