Axial Ablation versus Terminal Interruption of the Reflux Source (AAVTIRS): A Randomised Controlled Trial

Area of Science:

• Vascular Surgery
• Dermatology
• Wound Healing

Background:

• Reflux treatment improves Venous Leg Ulcer (VLU) healing.
• Terminal Interruption of the Reflux Source (TIRS) uses foam sclerotherapy to treat reflux around VLUs.
• The efficacy of TIRS for VLU management has not been previously evaluated.

Purpose of the Study:

• To compare the efficacy of TIRS versus axial ablation (AA) in treating VLUs.
• To assess the primary outcomes of VLU healing rates and time to healing.
• To evaluate secondary outcomes including quality of life.

Main Methods:

• A pragmatic, single-center, assessor-blinded, randomized controlled trial was conducted.
• Participants of any age with any duration of VLU were eligible.
• The study compared endovenous axial superficial vein ablation (AA) against TIRS.

Main Results:

• No significant difference was found in VLU healing rates between AA (70.9%) and TIRS (74.36%) at 6 months (P=0.45).
• Median time to ulcer healing was 84 days for both AA and TIRS groups.
• No significant differences in quality of life were observed between the two treatment groups.

Conclusions:

• The study did not demonstrate superiority of axial ablation over TIRS for VLU healing.
• TIRS is a potential treatment option for VLUs.
• Further investigation is required to establish TIRS as a recommended alternative to axial ablation for VLU treatment.