Randomized clinical trial of VNUS ClosureFAST radiofrequency ablation versus laser for varicose veins.
Shepherd AC, Gohel MS, Brown LC, Metcalfe MJ, Hamish M, Davies AH.
Br J Surg. 2010 Jun;97(6):810-8.
PMID:20473992

Radiofrequency endovenous ClosureFAST versus laser ablation for the treatment of great saphenous reflux: a multicenter, single-blinded, randomized study (RECOVERY study).
Almeida JI, Kaufman J, Göckeritz O, Chopra P, Evans MT, Hoheim DF, Makhoul RG, Richards T, Wenzel C, Raines JK.
J Vasc Interv Radiol. 2009 Jun;20(6):752-9. Epub 2009 Apr 22.
PMID: 19395275

В обоих случаях лазер гемоглобиновый (980нм).

Спасибо Андрею Красильникову - кое что прислал.

По отличиям от лазера. Мне видится 2 основных отличия:
1. Отсутствие карбонизации и, соответственно, перфораций. Вполне возможно, что в конце концов на лазер будут подобраны режимы (или созданы технические условия) позволяющие избегать карбонизации.
2. Выраженная констрикция вены непосредственно после процедуры. Это, как я понимаю, позволяет весьма надежно облитерировать вены крупного диаметра. Опять же, возможно, что лазер преодолеет и эту сложность.

После РЧА % реканализаций значительно меньше? Я не нашла таких исследований.

Br J Surg. 2010 Jun;97(6):810-8.

Randomized clinical trial of VNUS ClosureFAST radiofrequency ablation versus laser for varicose veins.Shepherd AC, Gohel MS, Brown LC, Metcalfe MJ, Hamish M, Davies AH.

Imperial Vascular Unit, Department of Surgery, Division of Surgery and Cancer, Imperial College, Charing Cross Hospital, London, UK.

Comment in:

Br J Surg. 2010 Jun;97(6):818-9.

Abstract
BACKGROUND: Endovenous laser ablation (EVLA) and radiofrequency ablation (RFA) are both associated with excellent technical, clinical and patient-reported outcomes for the treatment of varicose veins. The aim of this study was to compare the techniques in a randomized clinical trial.

METHODS: Consecutive patients with primary great saphenous vein reflux were randomized to EVLA (980 nm) or RFA (VNUS ClosureFAST) at a single centre. The primary outcome measure was postprocedural pain after 3 days. Secondary outcome measures were quality of life at 6 weeks, determined by the Aberdeen Varicose Vein Questionnaire (AVVQ) and Short Form 12 (SF-12), and clinical improvement assessed by the Venous Clinical Severity Score (VCSS). Analyses were performed on the basis of intention to treat using multivariable linear regression.

RESULTS: Some 131 patients were randomized to EVLA (64 patients) or RFA (67). Mean(s.d.) pain scores over 3 days were 26.4(22.1) mm for RFA and 36.8(22.5) mm for EVLA (P = 0.010). Over 10 days, mean(s.d.) pain scores were 22.0(19.81) mm versus 34.3(21.1) mm for RFA and EVLA respectively (P = 0.001). The mean(s.d.) number of analgesic tablets used was lower for RFA than for EVLA over 3 days (8.8(9.5) versus 14.2(10.7); P = 0.003) and 10 days (20.4(22.6) versus 35.9(29.4) respectively; P = 0.001). Changes in AVVQ, SF-12 and VCSS scores at 6 weeks were similar in the two groups: AVVQ (P = 0.887), VCSS (P = 0.993), SF-12 physical component score (P = 0.276) and mental component score (P = 0.449).

CONCLUSION: RFA using VNUS ClosureFAST was associated with less postprocedural pain than EVLA. However, clinical and quality-of-life improvements were similar after 6 weeks for the two treatments.

PMID: 20473992 [PubMed - indexed for MEDLINE