Things started changing in the varicose vein world in 1998.
A company called VNUS in the United States produced a radiofrequency catheter to treat varicose veins by destroying them with heat. This catheter was called VNUS Closure®. The VNUS Closure® catheter was about a metre long and the diameter of a biro refill, approximately 3 mm. When opened, a set of electrodes appeared from the end of the catheter which would be in contact with the vein wall. When electric currents were passed between these electrodes at radiofrequency rates, heat was generated in the vein wall only, destroying it completely.
Several things were revolutionary about the VNUS Closure® catheter. Firstly, because of the excellent ultrasound systems that were becoming available, the catheter could be positioned in the vein without needing to open the leg to see it. For the same reason, the catheter could be passed down a needle which had been inserted into the vein under ultrasound control.
This allowed surgeons to dispense with having to cut inside the groin and, instead, the catheter could be placed inside the vein below the knee and passed up inside the vein to the groin. Using the ultrasound, the catheter could then be opened at the groin, the vein be heated at this point, simulating a tie, and then slowly pulled back, destroying the vein on the way back.
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