Percutaneous treatment with radiofrequency ablation of varicose veins recurring after vein stripping surgery A preliminary study

Abstract

AIM: The aim of our study was to evaluate the efficacy of a new treatment of recurrent varicose vein after stripping of the great saphenous vein with rigid radiofrequency needles.

MATERIAL OF STUDY: 37 patients enrolled (11 males and 26 females). 10 patients had recurrent varicose veins for the presence of residual reflux in the Saphenous-Femoral Junction (SFJ) stump, whilst 21 patients for the presence of a single or multiple re-chanalized and refluxing perforator veins, and 6 had mixed rechanalization due to perforator veins and refluxing saphenous stump. All patients have been treated by percutaneous ultrasound-guided obliteration with radiofrequency needles. Treatment efficacy have been assessed by US evaluation, and/or the appearance of recurrent varicose veins and classified as REVAS questionnaire. Follow up has been carried out at 30, 60, 180 days and 1 year after treatment.

RESULTS: A complete obliteration of the perforator(s) stump(s) was observed in 12 procedures immediately after the treatment, and confirmed at 30 and 60 days. In 1 case (7.69 %) obliteration was not complete at 60 days. After 1 year of follow-up 3 perforators (23.07%) showed an incomplete or failed obliteration. A complete obliteration of the treated SFJ was observed in 27 cases at the end of the procedure and confirmed after 60 days of follow-up patients (Fig. 4). In 2 cases (6.89%), obliteration was non complete at 60 days. After 1 year of follow up 5 treated SFJ (17.24%) stumps showed an incomplete or a failed obliteration.

DISCUSSION: Results show a reduction of the number of limbs affected by ulcer, skin pigmentation and stasis eczema, demonstrating correction of haemodynamic overload to be effective.

CONCLUSIONS: This treatment is a new and effective solution to the problem of post-stripping recurrent varicose veins.