Mid and Long Term Results in Patients with Endovenous Radiofrequancy Ablation in Lower Extremity Venous Insufficiency

Abstract

Objective: Lower extremity venous insufficiency is a condition in which the flow of venous blood returns to the heart and the normal one-way rotation of the venous blood is reversed. As an alternative to open surgery in varicose veins, non-surgical endovascular procedures and hybrid endovascular procedures have emerged in the last decade. In this study, we aimed to evaluate the mid and long term results of endovenous radiofrequency ablation (RF) as an endovascular method. Methods: Between March 2015 and January 2017, 150 patients who underwent RF with the diagnosis of venous insufficiency were included in our study. 82 patients were female (54.7%), 68 were male (45.3%). The age range was 21-68 years old. Spinal anesthesia was performed in 139 patients and general anesthesia was performed in 11 patients. The RF ablation catheter was inserted into the Great Saphenous Vein (GSV) under the guidance of Doppler USG guided at the appropriate level below the knee. RF ablation was performed after approximately 1 cm distal of the superficial epigastric vein and then a flabectomy was performed. Result: Postoperative 1st 10th day, 1st 6th month and 1st 2nd year controls were performed. In control Doppler USG performed in sixth month, 135 patients (%90) had BSV complete occlusion and in 15 patients (%10) 40% recanalization. Six patients had deep venous insufficiency and 1 patient had perforating venous insufficiency. This patient developed varicose vein stockings in the medial malleolus and venous ulceration (C6) despite intensive medical therapy. Doppler USG performed in the first year of follow-up was 134 patients with GSV full occlusion and 16 patients with 40% recanalization. In the 2 year follow-up, there was no difference in the GSV patency rate between the first year and Doppler USG controls. Conclusion: We evaluated the mid and long term results of radiofrequency ablation in a single center, retrospectively in the treatment of venous insufficiency and varicose veins, which are common in the community. When applied with appropriate indication, radiofrequency ablation success rate is high, complication rate is low and it is also successful in terms of cosmetic results.