Five-year results from the prospective European multicentre cohort study on radiofrequency segmental thermal ablation for incompetent great saphenous veins

Abstract

BackgroundThis was a prospective study of radiofrequency segmental thermal ablation (RFA) for the treatment of incompetent varicose great saphenous veins (GSVs). The present report describes long-term follow-up at 5 years.MethodsThe 5-year follow-up of this multicentre European study included assessment of the Venous Clinical Severity Score (VCSS), and GSV occlusion and reflux on duplex imaging.ResultsA total of 225 patients had 295 GSVs treated by RFA, achieving an initial vein occlusion rate of 100 per cent. With 80·0 per cent compliance, Kaplan–Meier analyses showed a GSV occlusion rate of 91·9 per cent and a reflux-free rate of 94·9 per cent at 5 years. Among the 15 GSVs noted with reflux during follow-up, only three showed full recanalization of the GSV at 1 week, 6 months and 3 years. Of the 12 legs with partial recanalization, reflux originated at the saphenofemoral junction in ten, with a mean length of the patent segment of 5·8 (range 3·2–10) cm; only six patients were symptomatic. Mean(s.d.) VCSS scores improved from 3·9(2·1) at baseline to 0·6(1·2), 0·9(1·3) and 1·3(1·7) at 1, 3 and 5 years.ConclusionAt 5 years RFA proved to be an efficient endovenous treatment for incompetent GSVs in terms of sustained clinical and anatomical success for the vast majority of treated patients.

Is radiofrequency ablation of varicose veins a valuable option? A systematic review of the literature with a cost analysis

“…However, these new publications do not present results different from those presented here with the VNUS technology. [63][64][65][66] Indeed, these studies indicate that RFA is a safe procedure with minimal complications and with a clinical efficacy similar to that of open surgery. Importantly, one of the few studies with 5-year results indicates that RFA maintains occlusion rates of 91.9% and freedom from reflux in 94.9% of legs.…”

Comparative Study of Outcome of Duplex Ultrasound-Guided, Catheter-Directed Foam Sclerotherapy and Radio-frequency Ablation in the Management of Great Saphenous Varicose Veins

“…Studies have already proven the high occlusion rates of RFA maintained in short and middle terms [8,13,14]. There are relatively lesser studies on ultrasound-guided, catheterdirected foam sclerotherapy of varicose veins; however, they prove it to be safer and more efficacious when compared with the standard ultrasound-guided foam sclerotherapy [5,6,15].…”

Endovenous ablation of refluxing saphenous and perforating veins

“…) [13]. Follow-ups after fi ve years also showed durable and high occlusion rates of 91.9 %, with 94.9 % free of refl ux [43]. In 2012, a catheter with analogue function and a 3 cm heating element was introduced to treat vein segments too short to allow for placement of a 7 cm heating element.…”