Closure and Alternatives

	Closure^® Procedure	Vein Stripping & Ligation	Endovenous Laser (EVL)
Typical Results 48 Hours After Procedure	1	2	1
Proven Advantages over Vein Stripping in Randomized Comparative Trial	Quicker return to normal activities³ Less pain, bruising, and discomfort during early recovery³	N/A	No randomized comparative trial reported
Absence of Varicose Veins at 12 Months	90% of legs treated⁴	85% of legs treated⁶	This type of outcome not reported.
Return to Normal Activities within 24 Hours	89.1% of patients⁷	not reported	69.8% of patients⁷
Method of Action	RF energy delivered directly to the vein wall removes the vein wall lining and induces collagen contraction. Fibrosis of treated vein continues for months. By 6-12 months post-op, the fibrosed vein may be resorbed and become sonographically invisible.⁸		Laser energy boils the blood. A laser-induced steam bubble heats residual blood in the treatment vein producing thrombotic occlusion.⁹
Post-op Bruising	4%¹⁰	N/A	38%¹⁰
Patient Satisfaction	98% of patients surveyed would recommend to a friend⁵	not reported
Intraoperative Physician Feedback	Physicians receive real-time feedback during the procedure on key treatment parameters.	N/A	EVL systems have no intraoperative feedback systems.

1. Procedures performed at regional ACP Meeting, June 2001.
2. Data on File - VNUS Medical Technologies, Inc.
3. Lurie, F, et al.Prospective randomized study of endovenous radiofrequency obliteration (Closure procedure) versus ligation and stripping in a selected patient population (EVOLVeS Study), J Vasc Surg 2003; 38(2):207-14.
4. Merchant RF, DePalma RG, Kabnick LS. Endovascular obliteration of saphenous reflux: A multicenter study. J Vasc Surg 2002;35:1190-6
5. Weiss RA, et al. Controlled Radiofrequency Endovenous Occlusion Using a Unique Radiofrequency Catheter Under Duplex Guidance to Eliminate Saphenous Varicose Vein Reflux: A 2-Year Follow-up, Dermatologic Surgery, Jan 2002; 28:1: 38-42
6. Jones L, et al. Neovascularisation is the principal cause of varicose vein recurrence: results of a randomized trial of stripping the long saphenous vein, Eur J Vasc Endovasc Surg, 1996; 12: 442-445
7. Morrison N. Presented at the Union Internationale de Phlebologie, Rome, September 2001.
8. Pichot O, et al. Role of Duplex Imaging in Endovenous Obliteration for Primary Venous Insufficiency. J. Endovasc Ther 2000; 7:451-9.
9. Proebstle TM, et al. Endovenous Treatment of the Greater Saphenous Vein with a 940 nm Diode Laser: Thrombotic Occlusion after Endoluminal Thermal Damage by Laser Generated Steam Bubbles, J Vasc Surg 2002; 35: 729-736.
10. Morrison, N. Poster presented at American Venous Forum Meeting, February 2003.