Kathleen Gibson (Bellevue, USA) put the five-year data from the VeClose study, which looked at the treatment of patients with venous reflux in the great saphenous vein (GSV) with either the VenaSeal closure system (Medtronic) or radiofrequency ablation (RFA) therapy, front and centre during her interview with VEITHtv at the VEITHsymposium 2019 (19–23 November, New York, USA).
Gibson emphasises that longer-term data are very important and that the five-year results shows that, compared with the “gold standard” of RFA, the results are “very similar” both anatomically for vein closure and in terms of patient satisfaction and quality of life. The “excellent results” says Gibson, “gives us confidence that this is not just a short-term solution for patients but that it is more durable long-term”.
She also talks about her approach to patient selection when using VenaSeal, which involves the use of a permanent implant of cyanoacrylate adhesive and shares her patient information and consent process. Gibson notes that elderly patients who may not tolerate tumescent anaesthesia; those with thinner skin and propensity for bruising; those who cannot wear compression garments such as stockings; and those who seek to return rapidly to daily work and activities, would make particularly good candidates for the procedure—and that this makes 70– 80% of candidates in a mature vein practice.
Gibson’s view is that patients with chronic venous insufficiency and in particular those needing below-the-knee treatment, where thermal ablation techniques have some limitations due to skin and nerve damage, are most likely to benefit when VenaSeal, which is a non-thermal technology, is used. Interestingly and somewhat controversially, Gibson explains that she uses the technology to treat patients with venous ulceration (CEAP 6 patients) but that she does so only if the patient “does not have active infection”.
This video is sponsored by Medtronic.