Radiofrequency ablation of the great saphenous vein in the treatment of varicose veins of the lower extremities.

ABSTRACT

OBJECTIVE: The present study aims to investigate the therapeutic effect and safety of radiofrequency ablation (RFA) of the great saphenous vein in the treatment of varicose veins of the lower extremities. METHODS: Sixty-nine affected limbs of 45 patients were treated with RFA of the great saphenous vein. All patients underwent retrograde puncture of the distal great saphenous vein under the guidance of B-ultrasound. An RFA catheter was introduced 1 cm below the junction of the great saphenous vein and the femoral vein. A tumescent solution was injected around the femoral vein, and the great saphenous vein was ablated section by section from the upper part to the lower part. Twelve months after RFA, color Doppler ultrasound was used to evaluate the closure of great saphenous vein, and changes in the clinical class, etiology, anatomy, pathology (CEAP) classification before and after treatment were compared. The visual analogue score (VAS) was used to evaluate the local pain on the first and third day after operation. The incidence of complications (e.g., phlebitis, thrombosis, infection) was also evaluated. RESULTS: The ablation of the 69 affected limbs in all the 45 patients was successful. Instant B-ultrasound revealed occlusion of the great saphenous vein and the disappearance of blood flow immediately after ablation. There was no reoccurrence in all patients at the 12 month follow-up. The CEAP classification grade after treatment was significantly lower than that before the treatment, and the difference was statistically significant (χ2 = 4.188, P<0.05). The VAS scores on the first and third days after operation were 1.85 ± 0.35 and 0.59 ± 0.21, respectively. Pain was mild, and only two patients required painkillers. No complications were noted, with the exception of five cases of local ecchymosis. CONCLUSION: RFA of the great saphenous vein may represent an effective method for treating varicose veins of the lower extremities. RFA has the advantages of producing less trauma, fewer complications, and a lower incidence of recurrence. KEY WORDS B-ultrasonography, Pain, Radiofrequency ablation, Varicose veins.