Prospective randomized trial comparing radiofrequency ablation and complete saphenous vein stripping in patients with mild to moderate chronic venous disease with a 3-year follow-up

Abstract

Objective: To compare the use of the radiofrequency thermoablation of the saphenous vein with the ligation technique, and complete removal of the saphenous vein, from the saphenofemoral junction to the ankle. Methods: A total of 49 patients with chronic venous disease in the Comprehensive Classification System for Chronic Venous Disorders (CEAP) classes 2 to 4 for clinical signs, etiology, anatomic distribution and pathophysiology, were assessed at baseline, after 4 weeks, and after 1 year. The parameters assessed were complications, period of absence from activities, Venous Clinical Severity Score (VCSS) and quality of life scores according to Aberdeen Varicose Veins Questionnaire (AVVQ). They were re-examined 1 and 3 years after treatment to evaluate recurrence rates. Results: The success rate per limb (p=0.540), VCSS (p=0.636), AVVQ (p=0.163), and clinical complications were similar in the two treatment groups. Nevertheless, the radiofrequency thermoablation group had significant shorter length of hospital stay (0.69±0.47) and absence from activities (8.62±4.53), p<000.1. Conclusion: Patients submitted to radiofrequency thermoablation had an occlusion rate, clinical recurrence and improvement in quality of life comparable to removal of the saphenous vein. However, these patients spent less time hospitalized and away from their daily activities during recovering.

Comparison of Radiofrequency Ablation to Conventional High Ligation and Stripping in Truncal Varicosities

“…There was no statistically signicant difference in gender distribution among the study groups. [5] Similarly in a study done by Igor Rafeal Sincos et al showed that the mean age among patients of stripping group was 49.3 ± 11.7 years and in patients of RFA group was 44.1 ± 11.7 years which was not signicant (P value 0.128) among the study groups. Also in the study it was showed there was no statistical signicant difference in gender Similarly in a study done by Eleftherios S Xenos, Gabriel Bietz, David [6] J Minion et al showed the mean age of the patients of stripping group was 48.4 ± 5.44 years and in patients of RFA group was 47 ± 7.48 years which was not statistically signicant (P value 0.69).…”

Avaliação do coto residual após 12 meses de safenectomia sem ligadura alta da junção safeno-femoral

“… 16 - 19 Despite all of these benefits, scientific evidence from well-designed studies and long-term studies proving the superiority of endovenous techniques is still lacking. When compared, both offer similar improvement in quality of life 20 , 21 and both are considered safe and effective. 19 Long-term recurrence is still questioned, although the results for the two techniques after 3-5 years are similar, particularly when vascular US with Doppler is employed intraoperatively during conventional surgery.…”

“… 19 Long-term recurrence is still questioned, although the results for the two techniques after 3-5 years are similar, particularly when vascular US with Doppler is employed intraoperatively during conventional surgery. 20 , 22 …”

“…Apesar de todos os benefícios citados acima, ainda não há evidências científicas de estudos bem delineados e de longo prazo que comprovem a real superioridade das técnicas endovenosas. Quando comparadas, ambas proporcionam semelhante melhora da qualidade de vida 20 , 21 e são consideradas seguras e efetivas 19 . Ainda se questiona sua recorrência a longo prazo, com semelhança desse dado entre as técnicas após 3-5 anos, principalmente quando utilizado a US vascular com Doppler no intraoperatório das cirurgias convencionais 20 , 22 .…”

Management of Lower Extremity Pain from Chronic Venous Insufficiency: A Comprehensive Review

“…On the other hand, a subgroup meta-analysis by Bos et al in 2009 showed no significant differences in effectiveness between RFA and stripping [178]. Similarly, several other clinical trials evaluating RFA versus stripping surgery demonstrated improvement in clinical symptom indices without significant differences between treatment arms [188][189][190][191][192]. As with EVLA, RFA was found to result in lower immediate postoperative pain, lower complication rate, and decreased hospital length of stay [193].…”