Evaluation of Efficacy of Endovenous Radio Frequency Ablation for Varicose Veins in Industrial Workers—A Prospective Study

Abstract

Introduction The disease of varicose veins is a common vascular condition affecting one out of five in world population. Although conventional surgical treatments were considered the gold standard, they were fraught with many complications. Endovenous thermal interventions like endovenous radio frequency ablation (RFA) have largely superseded traditional surgery as the gold standard treatment as it is minimally invasive. Our initial experience with this treatment modality is presented along with the review of literature. Aim Our aim was to evaluate the efficacy, safety, clinical outcomes, and health economic benefits of endovenous RFA for varicose veins in our setup. Materials and Methods It was a prospective observational study conducted by the Department of General surgery at ESIC Medical College and Hospital, Hyderabad, India, from September 2020 to February 2021. Thirty consecutive patients with primary varicose veins were evaluated by detailed history, clinical examination, and venous Doppler study of the lower limbs. The procedure was performed under spinal anesthesia and Doppler ultrasound guidance using the ClosureFast (Medtronic) radio frequency segmental ablation system. Additionally, multiple stab phlebectomies were performed to deal with tributary varices in required cases. Various intraoperative (length of vein ablated and operative time) and postoperative (complications and return to work) variables were studied. Postoperative follow-up at 1,8,24 weeks was done clinically and using Doppler ultrasound to look for the recanalization of vein. The collected data were entered in Microsoft Excel spreadsheet and analyzed using descriptive statistics. Results The mean (standard deviation) age of patients was 39.1 (8.7) years. Ten patients had C2 disease, six C3, eleven C4, and three had C6 disease. The mean postoperative visual analog scale score on day 1 was 1.4. Mean return to normal activity time was 1.3 days. Average return to work time was 2.1 days. The post-procedure total occlusion rate at 24 weeks follow-up was 96%. Conclusion Endovenous RFA is a safe and effective minimally invasive modality for treating lower limb varicose veins, providing health economic benefits to patients.