A prospective randomized study comparing endovenous radiofrequency ablation and conventional surgery for primary great saphenous reflux

Elsayed Rezk Barakat, Yasser M.; Khattab, Mahmoud S.; Eldin, Sherif M.E.; AboElneel, Hamdy A.; Abd El-Salam Rizk, Mohamed Abd El-Monem

doi:10.4103/ejs.ejs_209_21

A prospective randomized study comparing endovenous radiofrequency ablation and conventional surgery for primary great saphenous reflux

Authors

Abstract

Background
Over the last 10–15 years, percutaneous endovenous ablation has largely replaced ligation and stripping of the great saphenous vein, which has been associated with high success and low complication rates.
Objective
The goal of this study was to compare the effectiveness of endovenous radiofrequency ablation (RFA) of primary varicose veins with conventional surgery in terms of pain, complications, recurrence, quality of life, and return to normal activities using standard parameters.
Patients and methods
Both methods were used on a total of 63 limbs (54 individuals) with great saphenous vein reflux and lower-limb varicose veins. Clinical and duplex ultrasound examinations, as well as quality-of-life assessments, were performed as part of the follow-up.
Results
There were no significant differences between both groups as regards the demographic data. The pain score shows a significant difference between both groups (<0.0001) in favor of the RFA group. Mean venous clinical severity scores improved from 5.73 ± 3.194 to 3.45 ± 2.279 at 1 month and 2.36 ± 1.851 at 6 months in the conventional surgery group and from 5.97 ± 3.538 to 3.10 ± 2.657 at 1 month and 1.80 ± 1.448 at 6 months in the RFA group. Complications represent 30.30% of patients in the surgical group compared with 16.67% of patients in the ablation group (=0.5668). There was a statistically significant difference as regards returning to normal activity (7.21 ± 1.634 days for the surgical group vs. 3.00 ± 1.323 days for the ablation group).
Conclusion
The occlusion incidence and clinical recurrence of individuals who received radiofrequency thermoablation were equal to those who underwent saphenous vein stripping. Patients who received radiofrequency thermoablation, on the other hand, had a better quality of life, experienced less postoperative discomfort, had a lower complication rate, and missed work for a shorter period of time in comparison with those who underwent the traditional technique.

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