Research Article
The Clinical Outcomes of Endovenous Radiofrequency Ablation of Varicose Veins: Two Year Follow up Results
Abstract
Aim: Our aim was to evaluate the two-year results of radiofrequency ablation (RFA) in the treatment of great saphenous vein (GSV) insufficiency.
Methods: A total number of 217 patients who underwent RFA (52.5 % male, mean age 42.7±11.4) were included in the study. RFA was performed in patients with great saphenous vein valvular incompetence and saphenofemoral junction incompetence. Occlusion status was recorded by ultrasonography. Venous clinical severity score (VCSS) was calculated pre- and post-intervention.
Results: The mean follow-up period of the patients was 22.2 ± 5.1 months. Cumulative survival rate (Kaplan–Meier) of 24-month follow-up was 84.3%. Complete occlusion rate for GSV was 100%, 98.6% ,97.6%, 97.6% and 97.6% for 1, 6, 12, 18 and 24 months follow up, respectively. VCSS was significantly different before RFA and 4 weeks after RFA (p < 0.001). No major complications were observed in the study.
Conclusion: In the treatment of GSV insufficiency, RFA is a safely applied method with high occlusion rates and obvious VCSS score decrease.
References
- 1. Leopardi D, Hoggan BL, Fitridge RA, Woodruff PW, Maddern GJ. Systematic Review of Treatments for Varicose Veins. Ann Vasc Surg. 2009;23(2):264–76. https://doi.org/10.1016/j.avsg.2008.10.007
- 2. Murad MH, Coto-Yglesias F, Zumaeta-Garcia M, Elamin MB, Duggirala MK, Erwin PJ, et al. A systematic review and meta-analysis of the treatments of varicose veins. J Vasc Surg, 2011;53(2):51-67. https://doi.org/10.1016/j.jvs.2011.02.031
- 3. Eroglu E, Yasim A. A randomised clinical trial comparing N-butyl cyanoacrylate, radiofrequency ablation and endovenous laser ablation for the treatment of superficial venous incompetence: two year follow up results. Eur J Vasc Endovasc Surg, 2018;56:553-560. https://doi.org/10.1016/j.ejvs.2018.05.028
- 4. Klein JA. Tumescent technique chronicles: local anesthesia, liposuction, and beyond. Dermatol Surg. 1995; 21:449–457. PMID: 8234507
- 5. Lohr J, Kulwicki A. Radiofrequency ablation: evolution of a treatment. Semin Vasc Surg. 2010; 23:90–100. https://doi.org/10.1053/j.semvascsurg.2010.01.004
- 6. Kapoor A, Mahajan G. Endovenous ablation of saphenofemoral insufficiency: analysis of 100 patients using RF closure fast technique Indian J Surg, 2010: 72;458-462. https://doi.org/10.1007/s12262-010-0160-y
- 7. Perrins S, Cha A, Qaqish R, Plummer D, Hsu R, Dietzek A. M. Clinical and anatomic outcomes of endovenous radiofrequency ablation performed on symptomatic small-diameter great saphenous veins, Journal of Vascular Surgery: Venous and Lymphatic Disorders, 2013;3(1):45-249. https://doi.org/10.1016/j.jvsv.2012.10.064
- 8. Kheirelseid EAH, Crowe G, Sehgal R, Liakopoulos D, Bela H, Mulkern E, et al. Systematic review and meta-analysis of randomized controlled trials evaluating long-term outcomes of endovenous management of lower extremity varicose veins. J Vasc Surg Venous Lymphat Disord. 2018;6(2):256-270. https://doi.org/10.1016/j.jvsv.2017.10.012
- 9. Bozoglan O, Mese B, Eroglu E, Erdogan MB, Erdem K, Ekerbicer HC, et al. Comparison of Endovenous Laser and Radiofrequency Ablation in Treating Varicose Veins in the Same Patient. Vasc Endovascular Surg. 2016;50(1):47-51. https://doi.org/10.1177/1538574415625813
- 10. Shepherd AC, Gohel MS, Brown LC, Metcalfe MJ, Hamish M, Davies AH. Randomized clinical trial of VNUSVR ClosureFAST radiofrequency ablation versus laser for varicose veins. Br J Surg 2010;97: 810–818. https://doi.org/10.1016/j.jvs.2010.09.043
- 11. Joh JH, Park HC, Kim WS, Jung IM, Park KH, Yun WS, et al. The Clinical Outcomes of Endovenous Radiofrequency Ablation of Varicose Veins: Results from the Korean Radiofrequency Ablation Registry. Korean J Vasc Endovasc Surg 2013;29(3):91-97. DOI: 10.5758/kjves.2013.29.3.91. https://doi.org/10.5758/kjves.2013.29.3.91
- 12. Catarinella FS, Nieman FH, Wittens CH. An overview of the most commonly used venous quality of life and clinical outcome measurements. J Vasc Surg Venous Lymphat Disord. 2015 Jul;3(3):333-40. https://doi.org/10.1016/j.jvsv.2014.09.003
- 13. Jin HY, Ohe HJ, Hwang JK, Kim SD, Kim JY, Park SC, et al. Radiofrequency ablation of varicose veins improves venous clinical severity score despite failure of complete closure of the saphenous vein after 1 year. Asian J Surg. 2017;40(1):48-54. doi: 10.1016/j.asjsur.2016.03.004. https://doi.org/10.1016/j.asjsur.2016.03.004
- 14. Casana R, Tolva VS, Odero A, Malloggi C, Parati G. Three-year follow-up and quality of life of endovenous radiofrequency ablation of the great saphenous vein with the ClosureFast™procedure: Influence of BMI and CEAP class. 2018;26(5):498-508. https://doi.org/10.1177/1708538118762066
- 15. Gloviczki P, Comerota AJ, Dalsing MC, Eklof BG, Gillespie DL, Gloviczki ML, et al. The care of patients with varicose veins and associated chronic venous diseases: clinical practice guidelines of the Society for Vascular Surgery and the American Venous Forum. J Vasc Surg. 2011;53(5):2-48. https://doi.org/10.1016/j.jvs.2011.01.079
- 16. Lurie F, Creton D, Eklof B, Kabnick LS, Kistner RL, Pichot O, 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: 207–214. https://doi.org/10.1016/S0741-5214(03)00228-3
- 17. Zuniga JM, Hingorani A, Ascher E. Short-term outcome analysis of radiofrequency ablation using ClosurePlus vs ClosureFast catheters in the treatment of incompetent great saphenous vein. J Vasc Surg 2012; 55: 1048–1051. https://doi.org/10.1016/j.jvs.2011.11.050
Kronik venöz yetmezlik olgularında Endovenöz Radyofrekans Ablasyonun Klinik Sonuçları: İki Yıllık Takip Sonuçları
Abstract
Amaç: Çalışmamızda büyük safen ven (GSV) yetmezliğinin tedavisinde radyofrekans ablasyonun (RFA) iki yıllık sonuçlarını değerlendirmeyi amaçladık.
Yöntemler: Çalışmaya RFA uygulanan toplam 217 hasta (%52,5 erkek, ortalama yaş 42.7 ± 11.4) dahil edildi. RFA işlemi büyük safen vende kapak yetersizliği ve safenofemoral bileşkede venöz reflü olan hastalara uygulandı. Oklüzyon takibi doppler ultrasonografi ile yapıldı. Müdahale öncesi ve sonrası Venous clinical severity score (VCSS) kayıt altına alındı.
Bulgular: Hastalar ortalama 22.2 ± 5,1 ay takip edildi. 24 aylık takipte kümülatif sağkalım oranı (Kaplan-Meier) %84,3 idi. GSV için tam oklüzyon oranı 1, 6, 12, 18 ve 24 aylık
takiplerde sırasıyla % 100,% 98.6,% 97.6,% 97.6 ve% 97.6 idi. RFA işleminden önce ve RFA uygulandıktan 4 hafta sonra hesaplanan VCSS değerleri anlamlı ölçüde farklıydı (p <0.001). Çalışma sırasında önemli bir komplikasyon gözlenmedi.
Sonuç: GSV yetmezliğinin tedavisinde RFA, yüksek oklüzyon oranları ve belirgin VCSS skoru düşüşü ile güvenli bir şekilde uygulanan bir yöntemdir.
References
- 1. Leopardi D, Hoggan BL, Fitridge RA, Woodruff PW, Maddern GJ. Systematic Review of Treatments for Varicose Veins. Ann Vasc Surg. 2009;23(2):264–76. https://doi.org/10.1016/j.avsg.2008.10.007
- 2. Murad MH, Coto-Yglesias F, Zumaeta-Garcia M, Elamin MB, Duggirala MK, Erwin PJ, et al. A systematic review and meta-analysis of the treatments of varicose veins. J Vasc Surg, 2011;53(2):51-67. https://doi.org/10.1016/j.jvs.2011.02.031
- 3. Eroglu E, Yasim A. A randomised clinical trial comparing N-butyl cyanoacrylate, radiofrequency ablation and endovenous laser ablation for the treatment of superficial venous incompetence: two year follow up results. Eur J Vasc Endovasc Surg, 2018;56:553-560. https://doi.org/10.1016/j.ejvs.2018.05.028
- 4. Klein JA. Tumescent technique chronicles: local anesthesia, liposuction, and beyond. Dermatol Surg. 1995; 21:449–457. PMID: 8234507
- 5. Lohr J, Kulwicki A. Radiofrequency ablation: evolution of a treatment. Semin Vasc Surg. 2010; 23:90–100. https://doi.org/10.1053/j.semvascsurg.2010.01.004
- 6. Kapoor A, Mahajan G. Endovenous ablation of saphenofemoral insufficiency: analysis of 100 patients using RF closure fast technique Indian J Surg, 2010: 72;458-462. https://doi.org/10.1007/s12262-010-0160-y
- 7. Perrins S, Cha A, Qaqish R, Plummer D, Hsu R, Dietzek A. M. Clinical and anatomic outcomes of endovenous radiofrequency ablation performed on symptomatic small-diameter great saphenous veins, Journal of Vascular Surgery: Venous and Lymphatic Disorders, 2013;3(1):45-249. https://doi.org/10.1016/j.jvsv.2012.10.064
- 8. Kheirelseid EAH, Crowe G, Sehgal R, Liakopoulos D, Bela H, Mulkern E, et al. Systematic review and meta-analysis of randomized controlled trials evaluating long-term outcomes of endovenous management of lower extremity varicose veins. J Vasc Surg Venous Lymphat Disord. 2018;6(2):256-270. https://doi.org/10.1016/j.jvsv.2017.10.012
- 9. Bozoglan O, Mese B, Eroglu E, Erdogan MB, Erdem K, Ekerbicer HC, et al. Comparison of Endovenous Laser and Radiofrequency Ablation in Treating Varicose Veins in the Same Patient. Vasc Endovascular Surg. 2016;50(1):47-51. https://doi.org/10.1177/1538574415625813
- 10. Shepherd AC, Gohel MS, Brown LC, Metcalfe MJ, Hamish M, Davies AH. Randomized clinical trial of VNUSVR ClosureFAST radiofrequency ablation versus laser for varicose veins. Br J Surg 2010;97: 810–818. https://doi.org/10.1016/j.jvs.2010.09.043
- 11. Joh JH, Park HC, Kim WS, Jung IM, Park KH, Yun WS, et al. The Clinical Outcomes of Endovenous Radiofrequency Ablation of Varicose Veins: Results from the Korean Radiofrequency Ablation Registry. Korean J Vasc Endovasc Surg 2013;29(3):91-97. DOI: 10.5758/kjves.2013.29.3.91. https://doi.org/10.5758/kjves.2013.29.3.91
- 12. Catarinella FS, Nieman FH, Wittens CH. An overview of the most commonly used venous quality of life and clinical outcome measurements. J Vasc Surg Venous Lymphat Disord. 2015 Jul;3(3):333-40. https://doi.org/10.1016/j.jvsv.2014.09.003
- 13. Jin HY, Ohe HJ, Hwang JK, Kim SD, Kim JY, Park SC, et al. Radiofrequency ablation of varicose veins improves venous clinical severity score despite failure of complete closure of the saphenous vein after 1 year. Asian J Surg. 2017;40(1):48-54. doi: 10.1016/j.asjsur.2016.03.004. https://doi.org/10.1016/j.asjsur.2016.03.004
- 14. Casana R, Tolva VS, Odero A, Malloggi C, Parati G. Three-year follow-up and quality of life of endovenous radiofrequency ablation of the great saphenous vein with the ClosureFast™procedure: Influence of BMI and CEAP class. 2018;26(5):498-508. https://doi.org/10.1177/1708538118762066
- 15. Gloviczki P, Comerota AJ, Dalsing MC, Eklof BG, Gillespie DL, Gloviczki ML, et al. The care of patients with varicose veins and associated chronic venous diseases: clinical practice guidelines of the Society for Vascular Surgery and the American Venous Forum. J Vasc Surg. 2011;53(5):2-48. https://doi.org/10.1016/j.jvs.2011.01.079
- 16. Lurie F, Creton D, Eklof B, Kabnick LS, Kistner RL, Pichot O, 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: 207–214. https://doi.org/10.1016/S0741-5214(03)00228-3
- 17. Zuniga JM, Hingorani A, Ascher E. Short-term outcome analysis of radiofrequency ablation using ClosurePlus vs ClosureFast catheters in the treatment of incompetent great saphenous vein. J Vasc Surg 2012; 55: 1048–1051. https://doi.org/10.1016/j.jvs.2011.11.050
There are 17 citations in total.
Details
| Primary Language | English |
|---|---|
| Subjects | Surgery |
| Journal Section | Research Article |
| Authors | |
| Publication Date | October 29, 2020 |
| Submission Date | June 16, 2020 |
| Acceptance Date | September 6, 2020 |
| Published in Issue | Year 2020 Volume: 4 Issue: 3 |
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