Endovenous Treatment Of Superficial Chronic Venous Disease In A Strict Ambulatory Setting: A Single-Center Experience

Minimally invasive endovenous techniques have become central to the treatment of superficial chronic venous disease (CVD) of the lower limbs. Their ability to avoid general or locoregional anaesthesia allows treatment to be performed in an outpatient setting.

To evaluate clinical and duplex ultrasound outcomes of endovenous treatment of superficial CVD performed exclusively in a strict ambulatory setting.

A retrospective observational study was conducted, including patients treated for superficial CVD between January 2017 and March 2019. Treatments modalities included radiofrequency ablation, catheter-directed foam sclerotherapy, and ultrasound-guided foam sclerotherapy by direct puncture. Clinical status was assessed using the CEAP classification. Duplex ultrasound follow-up was performed according to the institutional follow-up protocol.

Ninety-seven patients were included, with a mean age of 67 years and predominance of CEAP C2-C3 disease (86%). Axial reflux was treated by radiofrequency ablation in 78% of patients and catheter-directed foam sclerotherapy in 22%. At 12 months, 95% of treated saphenous segments were completely occluded, with a recanalization rate of 2.5%. CEAP reassessment at 12 months was available for 84 patients, of whom 87% were classified as CEAP C0-C1. All patients initially classified as CEAP C5 or C6 were lost to follow-up before the 12-month assessment. All procedures were performed on an outpatient basis, with same-day discharge.

Endovenous treatment of superficial chronic venous disease in a strict ambulatory setting was feasible and associated with high anatomical success at 12 months. Clinical follow-up findings were favorable among the assessed patients, but should be interpreted in light of the loss to follow-up among patients with more advanced baseline CEAP classes.