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Endovenous thermal ablation for venous insufficiency shows low recanalization rates for great and short saphenous veins. Accessory and perforator veins have higher recurrence rates, with redo procedures proving effective.

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Area of Science:

  • Vascular Surgery
  • Minimally Invasive Procedures
  • Venous Disease Management

Background:

  • Endovenous thermal ablation (ETA), including radiofrequency ablation (RFA) and endovenous laser ablation (EVLA), is a primary treatment for venous insufficiency.
  • While thrombotic complication rates are well-documented, recanalization rates after ETA require further investigation.

Purpose of the Study:

  • To evaluate recanalization rates after endovenous thermal ablation (ETA) for venous insufficiency.
  • To compare recanalization rates between RFA and EVLA.
  • To assess the effectiveness of repeat ablation procedures for recanalized veins.

Main Methods:

  • Retrospective chart review of 1475 ETAs in 485 patients (2012-2015).
  • Procedures included RFA (1027) and EVLA (448) targeting great saphenous (GSV), short saphenous (SSV), accessory saphenous (ASV), and perforator veins (PV).
  • Recanalization defined by specific diameter criteria; data correlated with patient demographics and vein type.

Main Results:

  • Overall low recanalization rates for GSV (7.7%) and SSV (8.5%) at 13.5 months.
  • Higher recanalization rates observed in PV (41.2%) and ASV (14.85%).
  • No significant difference in recanalization rates between RFA and EVLA; redo procedures had a 76.5% success rate.

Conclusions:

  • ETA demonstrates low recanalization rates for GSV and SSV.
  • Accessory and perforator veins exhibit significantly higher recurrence rates post-ablation.
  • Repeat ablation procedures are effective for managing recanalized veins, achieving a 76.5% success rate.