ClosureFast™ is a minimally invasive, endovenous procedure. It may also be referred to as endovenous radiofrequency ablation. To begin, the physician makes a tiny incision in the skin below the knee. Under ultrasound guidance, a catheter is inserted into the diseased vein through the small incision and advanced towards the groin. Small hypodermic needles are then used to inject a local anesthetic solution into the soft tissues immediately surrounding the diseased vein (this procedure is known as tumescent anesthesia). Radiofrequency energy is delivered to the vein via catheter in 20 second intervals over a short, 7 cm length of the diseased vein. The radiofrequency energy destroys the endothelial wall of the vein, triggering a collagen response to close the vein. Blood redirects to healthy veins and the diseased vein is absorbed by the body over time. The catheter is withdrawn slowly with each 7 cm application of radiofrequency energy. An entire diseased vein can be treated in this manner within several minutes. Afterwards, compression stockings are applied and should be used for a 4 week duration. Once the diseased vein is closed off, blood is re-routed to flow through normal veins.
Benefits: ClosureFast™ is minimally invasive and yields better cosmetic results than surgical stripping because only one, small incision is made. Additionally, there is less bruising and associated pain than with surgical stripping. Recovery time is substantially reduced with ClosureFast™ and patients can return to their normal activities faster than with vein stripping.
Limitations: When compared to the newest minimally-invasive technique, VenaSeal™, endovenous radiofrequency ablation requires tumescent anesthesia and the use of compression stockings after the procedure. Bruising is more prevalent than with VenaSeal™ and recovery time is also longer. ClosureFast™ is a heat-based procedure; burn damage to adjacent nerves and skin are potential rare side effects.
01: The disposable ClosureFast™ catheter is inserted into the diseased vein through a small incision and advanced towards the patients saphenofemoral junction (SFJ). 02: Radiofrequency (RF) energy is delivered to the vein via catheter in 20 second intervals over a short, 7 cm length of the diseased vein. The RF energy destroys the endothelial wall of the vein, triggering a collagen response to close the vein. 03: The catheter is withdrawn slowly following each 7 cm application of RF energy. The entire length of the diseased vein is now closed.
The disposable ClosureFast™ catheter.
The ClosureFast™ RF generator.
ClosureFast™ closure system animation. Courtesy of Medtronic.