Prospective nonrandomized comparison of quality of life and recurrence between high ligation and stripping and radiofrequency ablation for varicose veins

Objective Endovenous techniques are, at present, the recommended choice for truncal vein treatment. However, the thermal techniques require tumescent anaesthesia, which can be uncomfortable during administration. Non-tumescent, non-thermal techniques would, therefore, have potential benefits. This randomised controlled trial is being carried out to compare the degree of pain that patients experience while receiving mechanochemical ablation or radiofrequency ablation. The early results of this randomised controlled trial are reported here. Methods Patients attending for the treatment of primary varicose veins were randomised to receive mechanochemical ablation (ClariVein®) or radiofrequency ablation (Covidien® Venefit™). The most symptomatic limb was randomised. The primary outcome measure was intra-procedural pain using a validated visual analogue scale. The secondary outcome measures were change in quality of life and clinical scores, time to return to normal activities and work as well as the occlusion rate. Results One-hundred and nineteen patients have been randomised (60 in the mechanochemical ablation group). Baseline characteristics were similar. Maximum pain score was significantly lower in the mechanochemical ablation group (19.3 mm, standard deviation ±19 mm) compared to the radiofrequency ablation group (34.5 mm ± 23 mm; p < 0.001). Average pain score was also significantly lower in the mechanochemical ablation group (13.4 mm ± 16 mm) compared to the radiofrequency ablation group (24.4 mm ± 18 mm; p = 0.001). Sixty-six percent attended follow-up at one month, and the complete or proximal occlusion rates were 92% for both groups. At one month, the clinical and quality of life scores for both groups had similar improvements. Conclusion Early results show that the mechanochemical ablation is less painful than the radiofrequency ablation procedure. Clinical and quality of life scores were similarly improved at one month. The long-term data including occlusion rates at six months and quality of life scores are being collected.

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COST-EFFECTIVENESS OF RADIOFREQUENCY ABLATION VERSUS LASER FOR VARICOSE VEINS

International Journal of Technology Assessment in Health Care ◽

10.1017/s0266462315000537 ◽

2015 ◽

Vol 31 (5) ◽

pp. 289-296 ◽

Cited By ~ 12

Author(s):

Amanda C. Shepherd ◽

Marta Ortega-Ortega ◽

Manj S. Gohel ◽

David Epstein ◽

Louise C. Brown ◽

...

Keyword(s):

Quality Of Life ◽

Cost Effectiveness ◽

Radiofrequency Ablation ◽

Varicose Veins ◽

Cost Effective ◽

Clinical Severity ◽

Economic Implications ◽

Severity Scores ◽

Significant Difference

Objectives: Although the clinical benefits of endovenous thermal ablation are widely recognized, few studies have evaluated the health economic implications of different treatments. This study compares 6-month clinical outcomes and cost-effectiveness of endovenous laser ablation (EVLA) compared with radiofrequency ablation (RFA) in the setting of a randomized clinical trial.Methods: Patients with symptomatic primary varicose veins were randomized to EVLA or RFA and followed up for 6 months to evaluate clinical improvements, health related quality of life (HRQOL) and cost-effectiveness.Results: A total of 131 patients were randomized, of which 110 attended 6-month follow-up (EVLA n = 54; RFA n = 56). Improvements in quality of life (AVVQ and SF-12v2) and Venous Clinical Severity Scores (VCSS) achieved at 6 weeks were maintained at 6 months, with no significant difference detected between treatment groups. There were no differences in treatment failure rates. There were small differences in favor of EVLA in terms of costs and 6-month HRQOL but these were not statistically significant. However, RFA is associated with less pain at up to 10 days.Conclusions: EVLA and RFA result in comparable and significant gains in quality of life and clinical improvements at 6 months, compared with baseline values. EVLA is more likely to be cost-effective than RFA but absolute differences in costs and HRQOL are small.

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Levenskwaliteit een jaar na radiofrequente ablatie van de vena saphena magna

Tijdschrift voor Geneeskunde ◽

10.47671/tvg.77.20.116 ◽

2021 ◽

Author(s):

L. CRAEGHS ◽

B. BECHTER-HUGL ◽

S. THOMIS ◽

I. FOURNEAU

Keyword(s):

Quality Of Life ◽

Patient Satisfaction ◽

Radiofrequency Ablation ◽

Saphenous Vein ◽

Great Saphenous Vein ◽

Varicose Veins ◽

Self Image ◽

Patient Reported ◽

One Year

Quality of life one year after radiofrequency ablation of the great saphenous vein Symptomatic varicose veins have a negative impact on quality of life. Radiofrequency ablation (RFA) is an endovenous technique to occlude the venous lumen. In this study, the patient satisfaction and patient-reported quality of life is investigated one to two years after RFA of the great saphenous vein (GSV). Questionnaires were sent to 200 patients who were treated with RFA of the GSV at UZ Leuven more than one year ago. Data were processed using SPSS Statistics 24. 98 of 200 patients (49%) participated in this study. 80,4% (78/97) of patients were satisfied and 95,8% (92/96) would choose it all over again. Self image improved in 58,2% (57/98) and general health improved in 29,6% (29/98) of patients compared to a year ago. 57,4% (54/94) of patients had no relapse or progression one year after RFA of the GSV. Dissatisfaction was more common in patients with a history of varicose vein treatment, in patients with recurrent varicose veins or venous symptoms and in patients with postoperative hematoma. RFA of the GSV results in patient satisfaction among the participating patients and has a positive impact on their self image and on health-related quality of life more than a year after the treatment.

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Patient-reported quality-of-life after radiofrequency ablation of varicose veins compared to conventional surgery

Irish Journal of Medical Science (1971 -) ◽

10.1007/s11845-013-0944-8 ◽

2013 ◽

Vol 182 (4) ◽

pp. 639-642 ◽

Cited By ~ 1

Author(s):

R. Thompson ◽

A. Lewis ◽

C. Weir

Keyword(s):

Quality Of Life ◽

Radiofrequency Ablation ◽

Varicose Veins ◽

Conventional Surgery ◽

Patient Reported

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Impact on venous haemodynamics after treatment of great saphenous vein incompetence using plethysmography and duplex ultrasound

Phlebology The Journal of Venous Disease ◽

10.1177/0268355519898952 ◽

2020 ◽

Vol 35 (7) ◽

pp. 495-504

Author(s):

P Oskar E Nelzén ◽

Johan Skoog ◽

Malin Öster ◽

Helene Zachrisson

Keyword(s):

Quality Of Life ◽

Radiofrequency Ablation ◽

Saphenous Vein ◽

Strain Gauge ◽

Great Saphenous Vein ◽

Duplex Ultrasound ◽

Venous Occlusion ◽

High Ligation ◽

Strain Gauge Plethysmography

Objectives To evaluate postoperative venous haemodynamics and quality of life after treatment of great saphenous vein (GSV) incompetence. Methods Radiofrequency ablation and high ligation and stripping were performed in 62 patients (65 limbs) and 58 (65 limbs), respectively. Phlebectomies were performed in both modalities. Strain-gauge plethysmography on the foot combined with superficial venous occlusion was used to measure refilling time after knee bends. Strain-gauge plethysmography, duplex ultrasound and quality of life were assessed before and one month after treatment. Results Duplex ultrasound displayed successful intervention in all but two limbs. Refilling time increased similar in radiofrequency ablation and high ligation and stripping after treatment ( p < 0.001). Postoperatively, strain-gauge plethysmography detected remaining reflux in 71% of the patients. Multivariate analysis showed that two or more incompetent calf branches were associated with remaining reflux (OR 4.82 (95% CI: 1.33–17.5), p = 0.02). No difference in quality of life was seen in patients with remaining reflux. Conclusions Despite successful treatment, a majority of the limbs showed remaining reflux, in which incompetent calf branches appear to play an important role. Clinicaltials.gov: Lower Limb Venous Insufficiency and the Effect of Radiofrequency Treatment Versus Open Surgery. Nr: NCT02397226

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