A review of clinical efficacy, safety, and quality of life of ClosureFast™ radiofrequency ablation of saphenous vein insufficiency.

INTRODUCTION

This review aimed to systematically identify the efficacy, safety, and quality of life of ClosureFast™ radio frequency ablation (RFA) compared with other treatments for saphenous vein insufficiency.

EVIDENCE ACQUISITION: A systematic literature search was conducted using MEDLINE, EMBASE, Cochrane Central Register of Controlled Trials, World Health Organization-International Clinical Trials Registry Platform, and ClinicalTrials.gov from the time of their inception to June 2021. Randomised controlled trials (RCTs) comparing ClosureFast™ to surgery, endovenous laser ablation (EVLA), mechanochemical ablation (MOCA), foam sclerotherapy, or cyanoacrylate closure (CAC) were eligible for inclusion.

EVIDENCE SYNTHESIS: Thirty-two publications, representing 21 RCTs were included. Clinical efficacy (procedure success/failure) for ClosureFast™ was significantly better compared to Foam, MOCA, and other RFA devices, significantly poorer than CAC; and similar to high ligation and division, stripping, and EVLA. Symptom alleviation was similar between therapies; however, one study reported significantly worse symptom scores for ClosureFast™ compared to CAC. Compared with ClosureFast™, patients receiving EVLA treatment exhibited significantly higher pain scores, whereas CAC, MOCA, and other RFA groups reported lower pain scores. ClosureFast™ showed significantly lower rates of minor complications compared with EVLA in three studies, with rates of complication comparable with other treatments. ClosureFast™ patients returned to work or normal activity faster than surgical but slower than CAC patients. There was no difference in health-related quality of life and patient satisfaction between treatments.

CONCLUSIONS

ClosureFast™ has overall higher safety than EVLA and surgery, with better clinical efficacy than Foam, MOCA, and other RFA devices. Efficacy and safety of ClosureFast™ is comparable to or lower than CAC.