Factors affecting lower extremity venous insufficiency recurrence following radiofrequency ablation

To clarify possible factors for recurrence of venous insufficiency following radiofrequency ablation (RFA) for the treatment of lower extremity chronic venous insufficiency (CVI).

Patients with lower extremity CVI who underwent RFA therapy were reviewed for inclusion in the study. Patients' characteristics, operative parameters and follow-up outcomes were recorded. Patients were divided into two groups (patients with successful RFA and patients with recurrent venous insufficiency). Groups were compared according to patient demographic features, treated vein characteristics, operative data and follow-up duration.

In total, 313 patients matched the study inclusion criteria and 48 patients encountered RFA failure during follow-up. Mean BMI and ratio of COPD were significantly higher in patients with RFA failure (p = .002 and p = .007). The CEAP classification was significantly different between the groups (p = .007). Mean follow-up time was significantly longer in patients with RFA failure (p = .011). Presence of COPD and BMI ≥30 kg/m² increased RFA failure 4.187 times and 2.255 times, respectively (p = .002 and p = .022). Additionally, CEAP C4 significantly increased RFA failure (p = .001). Lastly, longer follow-up time was a predictive factor for RF failure (p = .024).

Our study findings demonstrated for the first time that obesity, presence of COPD, presence of veins classified as CEAP C4 before RFA, and follow-up period longer than 48 months were predictive factors for venous insufficiency recurrence following RFA.