Ann Surg Treat Res.  2023 Mar;104(3):164-169. 10.4174/astr.2023.104.3.164.

Endovenous radiofrequency ablation using a new bipolar electrode in a canine model: a new endovenous radiofrequency electrode

• Hwang JH
• Park SW
• Min J
• Yang WY
• Kwon YW
• Hwang JJ
• Kim JS
• Lee SA
• Chee HK

• KMID: 2539695
• DOI: http://doi.org/10.4174/astr.2023.104.3.164

Abstract

Purpose
This study aimed to determine the effectiveness and safety of a newly developed endovenous radiofrequency (RF) catheter compared with that of the existing RF catheter in a canine model.
Methods
Seven dogs underwent ablation using 1 control catheter (ClosureFAST, CF; Covidien) and 1 experimental catheter (VENISTAR, VS; STARmed Co., Ltd.) in the femoral and cephalic veins. The ablated vein was evaluated macroscopically (2,3,5-triphenyltetrazolium chloride staining, TTC), microscopically (hematoxylin and eosin staining), and ultrasonographically. Vessel injury score was used to evaluate the ablating effect objectively. Veins from 1 dog were evaluated on the day of ablation, while in the remaining 6 dogs, the ablated veins were evaluated 2 weeks later.
Results
A total of 23 veins (CF, 11 veins; VS, 12 veins) were ablated in 7 dogs. Non–TTC-stained vein wall areas were identified in all ablated veins. No significant difference was observed in the mean vessel injury score (2.54 ± 1.16 vs. 2.42 ± 1.13, P = 0.656) and the mean vessel wall thickness (0.32 ± 0.03 mm vs. 0.31 ± 0.05 mm, P = 0.212) between CF and VS. There was no blood flow in all veins ablated with VS, whereas there was remaining blood flow in 1 vein ablated with CF. Perivenous complication was not observed.
Conclusion
Endovenous RF ablation using a newly developed VS RF catheter seems to provide comparable occlusion rate and degree of vein wall injury without perivenous adverse events compared to the most commonly used RF catheter (CF).

Keyword

Canine model; Endovenous ablation; New electrode; Radiofrequency

Figure

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  Fig. 1 2,3,5-Triphenyltetrazolium chloride staining (TTC) stained ablated veins (follow-up day 14). Histologic specimen of cephalic veins of both sides in the same subject (the 4th dog) with (A) ClosureFAST (Covidien) and (B) VENISTAR (STARmed Co., Ltd.) shows TTC-unstained area suggesting loss of viability.

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  Fig. 2 H&E stained photomicrographs of damaged veins ablated with CF (A–C) and VS (D–F). (A) The entire cross section of cephalic vein in the 6th dog ablated with CF. (B) Enlarged image of the red dotted box in panel A. Destruction of endothelial cell layer with some blood cells (arrowheads) adjacent to the injured endothelial layer. (C) Enlarged image of the blue dotted box in panel A. The elastic fibers are not observed and clefts (arrowhead) are noted in the tunica media. (D) The entire cross section of cephalic vein in the 7th dog ablated with VS. (E) Enlarged image of the red dotted box in panel D. Destruction of endothelial cell layer and disintegration with lots of clefts in the tunica intima and media (arrowheads). (F) Enlarged image of the blue dotted box in panel D. Clefts noted in the tunica adventitia (arrowheads). a, tunica adventitia; m, tunica media; i, tunica intima; CF, ClosureFAST (Covidien); VS, VENISTAR (STARmed Co., Ltd.).

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  Fig. 3 Measurement of vessel injury score (A) and vessel wall thickness (B). CF, ClosureFAST (Covidien); VS, VENISTAR (STARmed Co., Ltd.).

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