Radiofrequency ablation of varicose veins improves venous clinical severity score despite failure of complete closure of the saphenous vein after 1 year

Jin, Hyeong Yong; Ohe, Haeng Jin; Hwang, Jeong Kye; Kim, Sang Dong; Kim, Jang Yong; Park, Sun Cheol; Kim, Ji Il; Won, Yong Sung; Yun, Sang Seob; Moon, In Sung

doi:10.1016/j.asjsur.2016.03.004

Cited by 24 publications

(19 citation statements)

References 17 publications

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“…A study by Jin HY et al of 117 patients with 1 year follow up showed an almost similar results with a success rate of 97.7% and a significant improvement of VCSS in the failure group also. 6 Giuseppe G et al, in a single centre study of 98 patients, had a 95.4% occlusion rate at 6 months follow up with a significant improvement in CEAP score over 6 months. 7 The recovery study showed a significant improvement in VCSS score in RFA limbs correlating to reduced postoperative pain and edema.…”

Section: Discussionmentioning

confidence: 93%

Efficacy and safety of radiofrequency ablation for lower limb varicose veins

De¹,

Roy²,

Kumar³

2018

Int Surg J

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Background: Endovenous Radiofrequency Ablation (RFA) is gradually gaining widespread acceptance as a minimally invasive modality for treatment of varicose veins (VV). The objective of this study was to evaluate the efficacy based on Venous Doppler and Venous Clinical Severity Score (VCSS) and the safety of radiofrequency ablation for varicose veins.Methods: This is a prospective study of 58 consecutive patients who underwent Radiofrequency ablation of Varicose veins from January 2015 to January 2017 in a single unit of a Multispecialty Tertiary Care Hospital. The mean age was 44.10±13.74 years (19-75 years). A total of 78 limbs were treated in 58 patients. RFA was performed using Closure FastTM catheter according to the manufacturer’s recommendation. Treatment outcomes were estimated 15 days, 3 months, 6 months and 1 year after the procedure using Doppler scan and VCSS score.Results: There was 100% occlusion of the treated veins with no evidence of partial/complete recanalization. However, 2 (2.56%) patients had a GSV stump length > 3cm on Doppler at 6 months, without evidence of significant reflux. Minor complications such as ecchymosis erythema, pain and induration rapidly improved over short term. One patient (1.3%) had evidence of Deep Vein thrombosis (DVT) on follow up Venous Doppler. The mean VCSS improved from mean of 7.98 preoperatively to 2.24 after 1 year (P value <0.001).Conclusions: Radiofrequency ablation is a safe and effective procedure with minimal major complications. The minor complications were early and resolved rapidly.

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Section: Discussionmentioning

confidence: 93%

Efficacy and safety of radiofrequency ablation for lower limb varicose veins

De¹,

Roy²,

Kumar³

2018

Int Surg J

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“…27 This is similar to reports from another retrospective study using prospectively registered data with one year follow up reported in 2017. 28 Approximately 92% of patients were satisfied with the procedures. This was consistent with low pain score (under 2) in both groups and a comparable regret rate.…”

Section: Discussionmentioning

confidence: 95%

Editor's Choice – Role of Compression After Radiofrequency Ablation of Varicose Veins: A Randomised Controlled Trial☆

Onwudike

Abbas

Thompson

et al. 2020

European Journal of Vascular and Endovascular Surgery

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This study examined the effect of post-procedure leg compression in a full range of patients with superficial truncal incompetence treated exclusively with radiofrequency ablation (RFA). There was no significant difference in the target vein occlusion rate, quality of life, venous clinical severity score, patient satisfaction, and pain score with or without compression. This study provides further evidence that varicose vein patients undergoing RFA may not require post-procedure compression. Objective: Post-procedure limb compression, hitherto routine following open varicose vein surgery, has been extended to endovenous procedures. However, no robust evidence exists to support this practice. Most of the previous studies have focused on the ideal duration of compression. This study evaluates the clinical and patient reported outcomes with and without post-procedure leg compression following radiofrequency ablation (RFA). Methods: This single centre, prospective, non-inferiority randomised controlled trial recruited adult patients, into two groups (A: RFA with compression stocking for two weeks, B: RFA alone). The primary outcome was ultrasound determined target vein obliteration at 12 weeks. Secondary outcome measures included a Quality of Life (QoL) score [Aberdeen Varicose Vein Severity Score (AVSS) and Revised Venous Clinical Severity Score (RVCSS)], patient satisfaction, pain score, and complications. Results: In total, 100 consecutive patients were recruited (A: 51; B: 49) classified as clinical class C2eC6 of the Clinical-Etiological-Anatomical-Pathophysiological (CEAP) classification. At 12 weeks the occlusion rate of the target vein was similar in both groups at 98% (n ¼ 47) and 98% (n ¼ 45), respectively (p ¼ 1.0). There was no statistically significant difference in mean AVSS 6 vs. 5.0 (mean difference À1, 95% CI À2 e 3, p ¼ .57) and mean RVCSS 3 vs. 4 (mean difference 1, 95% CI À1 e 2, p ¼ .46) scores at 12 weeks. Comparable patient satisfaction scores were observed (p ¼ .72) and pain score 2.0 vs. 2.0 (p ¼ .92) were achieved in both groups. Two patients in each group developed deep vein thrombosis at two weeks follow up (p ¼ 1.0 for above the knee and p ¼ 1.0 for below the knee). Conclusion: The clinical and patient reported outcomes following RFA without compression are no worse than with compression. This trial supports the conclusion that the widely practised use of compression after RFA adds no clinical benefit for the patients. However, a much larger study, preferably a multicentre trial, may be required to confirm this conclusion.

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“…However, one of the patients had no complaints about venous insufficiency, corroborating the recent publications that have demonstrated ablation of the saphenous vein improves VCSS, despite failing to close it completely. ( 26 ) Recently, the results of the original VNUS closure device to eliminate truncal venous reflux at 15 years were reported, demonstrating excellent long-term technical success in truncal veins with the first-generation device. ( 27 )…”

Section: Discussionmentioning

confidence: 99%

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

Sincos¹,

Baptista²,

Neto³

et al. 2019

Einstein (São Paulo)

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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.

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Radiofrequency ablation of varicose veins improves venous clinical severity score despite failure of complete closure of the saphenous vein after 1 year

Abstract: In this study, RFA of varicose veins had an initial success rate of 97.7% and a significantly improved patient VCSS at 1 year. Patients with episodic recanalization of the saphenous vein also exhibited an improved VCSS with favorable duplex findings at 1 year.

Cited by 24 publications

References 17 publications

Efficacy and safety of radiofrequency ablation for lower limb varicose veins

Efficacy and safety of radiofrequency ablation for lower limb varicose veins

Editor's Choice – Role of Compression After Radiofrequency Ablation of Varicose Veins: A Randomised Controlled Trial☆

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

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