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

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.

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.

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.

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.

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

Perforator veins, Radiofrequency, Recurrent post-stripping varicose veins, Saphenofemoral stump.