Endovenous laser and radiofrequency ablation therapies in superficial venous insufficiency

Superficial venous insufficiency is a common problem associated with varicose veins. In addition to classical symptoms, it may result in skin changes, venous ulcers and has a great impact on patients' health-related quality of life. In the last decade, minimally invasive techniques such as endovenous laser ablation (EVLA) and radiofrequency ablation (EVRFA) have been developed as alternatives to surgery in an attempt to reduce morbidity and improve efficiency. The aim of this study is to evaluate the efficacy of EVLA and EVRFA therapies in superficial venous insufficiency. Fifty-four legs belonging to 49 patients with symptomatic primary venous insufficiency were treated. Thirty-two great saphenous veins and 5 small saphenous veins were treated with 980 nm diode laser, while 16 great saphenous veins and 1 small saphenous vein were treated with bipolar Radiofrequency Induced Thermotherapy (RFITT). All patients underwent postoperative duplex scanning within one week and one month after the procedure and followed clinically, to determine the severity of the venous disease. Venous Clinical Severity Score (VCSS) and Visual Analogue Scale (VAS) were administered before the procedures and repeated one month after the procedure. Complications and occlusion rates were recorded. Total occlusion rates in RFITT and EVLA groups were 94,1% and was 100%, respectively. There was no significant difference between groups (p=0,140). Major complications such as skin burns, deep venous thrombosis have not been detected for both groups. Ecchymoses were observed 70% in EVLA group with a duration average of one week and were not observed in RFITT group. Postoperative pain scores were significantly less in RFITT group than EVLA group (p<0,05). VCSS and VAS scores before and one month after the procedure were compared and significant decrease for both procedures was observed (p<0,01). There was no significant difference in postoperative VCSS scores between two treatment groups (p=0,126). EVLA and EVRFA therapies in saphenous vein insufficiency are effective, minimally invasive, safe, easy to use treatment modalities with good patient satisfaction and high occlusion rates. RFITT system is quite effective in the short term closure of the main veins. Complications after the procedure are less and patient comfort is superior to EVLA, however long-term and extensive studies are required to confirm the efficacy. Key words: RFITT, Saphenous Vein, Catheter Ablation