Combined radiofrequency ablation and truncal foam sclerotherapy for greater saphenous vein incompetence can reduce recurrence and complications of radiofrequency ablation

Gameel, Abdelrahman M.; Elsherbeni, Mohamed E.; Elboushi, A.; Samir, Ayman M.; Sorour, Waleed A.; Tawfik, Ahmed M.; Salem, Ayman

doi:10.4103/ejs.ejs_94_17

Combined radiofrequency ablation and truncal foam sclerotherapy for greater saphenous vein incompetence can reduce recurrence and complications of radiofrequency ablation

Authors

Abstract

Objective
Although radiofrequency ablation (RFA) has been established as an effective method for the treatment of lower limb varicose veins with a good outcome, in all interventions, there were complications and recurrence, because of which in this study we are modifying our technique to reduce the rate of complications and recurrence that we faced in our previous work.
Patients and methods
A total of 74 patients (86 lower limbs) with greater saphenous vein (GSV) incompetence were randomized to two treatment groups; the first group was treated by RFA with duplex guided perforator injection and the second group was treated by RFA with duplex guided perforator injection plus below knee truncal sclerotherapy of incompetent GSV. Groups were followed up for 12 months and compared demographically; venous clinical severity scores (VCSS), need for sclerotherapy during follow-up and postintervention complications including recanalization and recurrence were determined.
Results
There was no statistically significant difference between both groups as regards demographic criteria, VCSS preoperatively, paresthesia around the medial malleolus and recurrence of varicose veins during the follow-up period. There was significant difference between both groups as regards GSV recanalization with a value of 0.046; also there were significant difference between four different time periods of VCSS (preintervention, 3, 6 and 12 months postintervention) by pairwise comparison of the two groups. A significant difference was found between the two groups in the need for postintervention sclerotherapy all over 12 months with a value of 0.038.
Conclusion
The addition of below knee truncal sclerotherapy to the above knee RFA of GSV can reduce the rate of recanalization, recurrence of varicose veins, and decrease the need for postintervention sclerotherapy without risk of increase in the total number of complications.

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