Preliminary Study Of Radiofrequency Closure Of Small Vessel

Background: Congenital vascular malformations (VM) still remain one of the most difficult diagnostic and therapeutic enigmas in modern medicine due to its extremely variable clinical presentation ranging from asymptomatic birthmarks to life threatening conditions. As a new technique for obliteration of vessels, radiofrequency closure (RFC) may be a more safe and effective method for the treatment of cutaneous venous malformation.Objective: To demonstrate the short-term (<1month) efficacy of RF closure of small vessel. And to find out if RF closure can induce activation of the hemostatic system.Materia and Methods: The first part: Twenty four hind legs with radiofrequency closure of the superficial femoral veins were followed up with high-resolution ultrasound imaging 30min to 1 month after the procedure. Ultrasound was used to evaluate rabbits for small vessel networks, and concomitant findings of small vessel networks and recanalization at the treated area. The ablation area was studied by macroscopy and histological analysis respectively before RFC and 30min, 1w, 4w after RFC. The second part: Twenty rats, group 1 (n = 6) without any treatment, group 2 (n = 6) during routine abdominal surgery (RAS), and group 3 (n=8) during RFC, were studied prospectively. Blood was drawn at intervals of 48h in group 1, 30min and 48h after completion of RF and RAS in group 2 and group 3. Plasma soluble P-selectin was measured by enzyme-linked immunosorbent assay (ELISA).Results: In the first part of this study, we found recanalization in 2 hind legs 3w after RFC. In the second part of this study, we found both group 2 and group 3 had increased platelet adhesion, as determined by increased plasma soluble P-selectin compared to the group 1 (P<0.05). There was significant difference among three groups.Conclusion: The short-term (<1 month) efficacy of RF closure of small vessel was significant. And the increased plasma soluble P-selectin bear clinical significance since P-selectin has been implicated in the pathogenesis of wide-spread disorders including coronary artery disease, stroke, diabetes and malignancy.