Prospective study of safety and effectiveness in the use of radiofrequency ablation for incompetent great saphenous vein ≥12 mm

Fernández, Maday Cabrero; López, I. Martínez; Mateo, Manuela Maria Hernandez; Marino, Pablo Marqués de; Artero, Iñaki Cernuda; Hernando, F.J. Serrano

doi:10.1016/j.jvsv.2017.05.021

Cited by 18 publications

(16 citation statements)

References 24 publications

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“…A combined procedure with Radiofrequency Ablation (RFA) and USGFS, is safe and successful and can become an important treatment option. 15 , 16 However, there are limited data on the efficacy and safety of this combined procedure in patients with large GSV diameters.…”

Section: Introductionmentioning

confidence: 99%

Radiofrequency Ablation for Axial Reflux Associated with Foam Sclerotherapy for Varicosities in One-Step Approach: A Prospective Cohort Study Comprising Large Diameters Saphenous Veins

Poschinger-Figueiredo¹,

Virgini-Magalhães²,

Pôrto³

et al. 2021

VHRM

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Objective This study assessed the outcomes and impact on the quality of life following one-step outpatient radiofrequency ablation (RFA) and ultrasound guided foam sclerotherapy (USGFS) for large reflux with varicosities in the great saphenous vein (GSV). Design Prospective, single-centre, analytical cohort. Materials and Methods Thirty symptomatic patients having reflux in the GSV and varicosities (CEAP C3 to C6) were treated with RFA and USGFS simultaneously, in a single-step procedure, from March 2016 to December 2016. They were followed up at 1 week, 6 months, 1 and 3 years. Clinical outcomes, changes in the Quality of Life (QOL) questionnaires SF-36™, VCSS and AVVQ, evolutive vein occlusion rates were assessed by duplex ultrasound, and ulcer closure was checked. Results The sample was divided into two groups: (Group 1) GSV diameter ≥13.0 mm (median 19.0 [14–24]), 17 subjects, and (Group 2) GSV diameter ≤12.9 mm (median 10.3 [10–12]), 16 subjects. No major adverse event was observed, and the postoperative minor adverse event rates were similar between the two groups. A significant improvement was observed in VCSS and AVVQ from the preoperative levels to the sixth month and the third-year follow-up. Twelve of 13 ulcers had healed at 1 year and remained closed until 3 years. The entire sample had a significant increase in all short form 36 domains, except for mental health in the Group 2 (GSV ≥ 13.0 mm). Overall first week occlusion rate for the whole sample was 90.9% and 69.7% at the 3-year follow-up. No difference in occlusion rate was observed between the two groups at any time. Conclusion Exclusively outpatient combined techniques were safe and feasible in this study with no major adverse events, despite the large diameters of the GSV or ulcer presence. Within 3 years, both diameter groups showed equivalent improvement in all QOL parameters, satisfactory axial occlusion, and maintained ulcer closure.

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Section: Introductionmentioning

confidence: 99%

Radiofrequency Ablation for Axial Reflux Associated with Foam Sclerotherapy for Varicosities in One-Step Approach: A Prospective Cohort Study Comprising Large Diameters Saphenous Veins

Poschinger-Figueiredo¹,

Virgini-Magalhães²,

Pôrto³

et al. 2021

VHRM

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“…There were few reports which analyzed these indexes in association with GSV diameter before. We evaluated clinical improvement after RFA using both the VCSS and the AVSS, unlike to a recent study on RFA in large diameter veins [12]. With this, we showed comprehensive results of RFA in larger diameter GSV.…”

Section: Discussionmentioning

confidence: 99%

“…RFA of great saphenous veins (GSVs) larger than 12 mm in diameter has been controversial because of an increased risk of incomplete obliteration and target vein phlebitis [89]. After the current second generation ClosureFast (Venefit, Covidien, Mansfield, MA, USA) catheter was introduced in 2007, with routine use of tumescent anesthesia, the 12-mm size limitation is no longer considered issue [101112]. However, there is limited data on both the efficacy and safety of RFA for saphenous veins with a large diameter.…”

Section: Introductionmentioning

confidence: 99%

Outcome of ClosureFAST radiofrequency ablation for large-diameter incompetent great saphenous vein

Woo

Kim

et al. 2019

Ann Surg Treat Res

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Purpose There is limited data on the outcomes of radiofrequency ablation (RFA) for large diameter saphenous veins. This study aimed to determine whether the large-diameter great saphenous vein (GSV) affected closure rate, complications, and clinical and quality of life (QoL) improvement. Methods From January 2012 to September 2016, a total of 722 limbs were treated with ClosureFAST RFA in a single center. Patients were divided into 2 groups according to the vein diameter measured 3 cm below the saphenofemoral junction (group A ≤ 12 mm, group B > 12 mm). Vein closure was evaluated with duplex scan at 3–5 days, 1, 3, 6, and 12 months postoperatively. The incidence of complications, improvements in symptoms (measured by the Venous Clinical Severity Score [VCSS]) and QoL (measured by the Aberdeen Varicose Vein Symptom Severity Score [AVSS]) were evaluated. Results Groups consisted of 663 GSVs in group A (mean diameter, 6.00 ± 1.74 mm) and 59 in group B (mean diameter, 13.17 ± 1.28 mm). Vein closure rates at 12 months were 98.9% in group A and 100% in group B (P = 0.428). There was no significant difference in the incidence of complications. Both groups showed marked improvements in the VCSS and the AVSS with no significant differences. Conclusion For large-diameter veins, RFA showed comparable outcomes in terms of closure rate, complications, clinical and QoL improvements.

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“…Seven studies, four comparative case series, and three noncomparative case series comprised of 2552 patients, and 2564 GSV were finally included. Three studies described interventions for GSV of diameters exceeding 12 mm, and four studies depicted interventions for GSV larger than 13 mm [11][12][13][14][15][16][17] (Table 1).…”

Section: Baseline Study Characteristicsmentioning

confidence: 99%

“…13,16,17 Two studies reported on superficial thrombophlebitis. 13,16 Comparative analysis between ablation of GSV > 12 mm and GSV < 12 mm Three studies portraying RFA ablation reported on GSV occlusion outcomes comparing GSV smaller and larger than 12 mm. One study investigating EVLA ablation reported on occlusion outcomes between GSV of diameters greater and smaller than 13 mm.…”

Section: Overall Endovenous Thermal Ablation Efficacy and Safetymentioning

confidence: 99%

Endovenous thermal ablation in the treatment of large great saphenous veins of diameters > 12 mm: A systematic review meta-analysis and meta-regression

Bontinis

Koutsoumpelis

et al. 2023

Vasc Med

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Background: We sought to assess the safety and efficacy of endovenous thermal ablation (EVTA) in treating large great saphenous veins (GSV) > 12 mm in diameter. Methods: We performed a systematic review according to the Preferred Reporting Items for Systematic reviews and Meta-Analyses (PRISMA) 2020 for comparative and noncomparative studies depicting EVTA in the treatment of GSV > 12 mm. Primary endpoints included GSV occlusion, technical success, deep vein thrombosis (DVT), and endovenous heat-induced thrombosis (EHIT). We conducted a comparative analysis between GSV > 12 mm and < 12 mm and a meta-regression analysis for two sets of studies, one including the whole dataset, containing treatment arms of comparative studies with GSV < 12 mm and one exclusively for GSV > 12 mm. Results: Seven studies, including 2564 GSV, depicting radiofrequency (RFA) and endovenous laser ablation (EVLA) were included. GSV > 12 mm occlusion, technical success, DVT, and EHIT estimates were 95.9% (95% CI: 93.6–97.8), 99.9% (95% CI: 98.9–100.0), 0.04% (95% CI: 0.0–3.4), and 1.6% (95% CI: 0.3–3.5). Meta-regression revealed a negative association between GSV diameter and occlusion for both the whole dataset ( p < 0.01) and the > 12 mm groups ( p = 0.04), GSV diameter and technical success for both groups ( p < 0.01), ( p = 0.016), and GSV diameter and EHIT only for the whole dataset ( p = 0.02). The comparative analysis between GSV < 12 mm and GSV > 12 mm displayed an occlusion estimate of OR 1.79 (95% CI: 1.25–2.56) favoring small GSV. Conclusion: Whereas we have displayed excellent occlusion and technical success results for the EVTA of GSV > 12 mm, our analysis has illustrated the unfavorable impact of GSV diameter on occlusion, technical success, and EHIT outcomes regardless of the 12 mm threshold. Potential parameter or device adjustments in a diameter-oriented fashion could further enhance outcomes.

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Prospective study of safety and effectiveness in the use of radiofrequency ablation for incompetent great saphenous vein ≥12 mm

Cited by 18 publications

References 24 publications

Radiofrequency Ablation for Axial Reflux Associated with Foam Sclerotherapy for Varicosities in One-Step Approach: A Prospective Cohort Study Comprising Large Diameters Saphenous Veins

Radiofrequency Ablation for Axial Reflux Associated with Foam Sclerotherapy for Varicosities in One-Step Approach: A Prospective Cohort Study Comprising Large Diameters Saphenous Veins

Outcome of ClosureFAST radiofrequency ablation for large-diameter incompetent great saphenous vein

Endovenous thermal ablation in the treatment of large great saphenous veins of diameters > 12 mm: A systematic review meta-analysis and meta-regression

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