J Korean Surg Soc.  2013 Feb;84(2):107-113. 10.4174/jkss.2013.84.2.107.

The occlusion rate and patterns of saphenous vein after radiofrequency ablation

• Choi JH
• Park HC
• Joh JH

• KMID: 2144998
• DOI: http://doi.org/10.4174/jkss.2013.84.2.107

Abstract

PURPOSE
Radiofrequency ablation (RFA) is a widely accepted to treat the varicose vein. However, outcome studies for occlusion rate and patterns of the saphenous vein after RFA are scarce. The purpose of our study is to report the results of RFA in patients with varicose vein.
METHODS
We retrospectively reviewed the clinical outcomes after RFA using ClosureFAST (Covidien) catheter. We evaluated the occlusion rate and patterns with duplex scanning after RFA.
RESULTS
A total of 200 limbs (148 patients) underwent RFA. The truncal veins were ablated in 163 great saphenous veins (GSV) and 41 small saphenous veins (SSVs). The mean age was 52.1 +/- 11.9 years and female to male ratio was 125 : 87. At the mean follow-up of 13.9 months, the CEAP score, VCSS, and QoL score were significantly improved 2.33 +/- 0.78 to 1.29 +/- 0.96 (P < 0.0001), 3.48 +/- 0.98 to 0.63 +/- 1.16 (P < 0.0001), and 6.91 +/- 6.69 to 3.38 +/- 4.74 (P < 0.0001), respectively. The occlusion rate was 94.6% (53/56) in GSV and 94.5% (17/18) in SSV. The most common occlusion pattern in GSV was total occlusion of main trunk with patent superficial inferior epigastric vein in 41.1%. And, the most common pattern in SSV was the total occlusion of SSV with stump in 66.7%.
CONCLUSION
RFA is an effective modality in the treatment of varicose vein. At the mean follow-up of 13.9 months, the occlusion rate was 94.6%in GSV and 94.5% in SSV. There are several patterns of saphenous occlusion after RFA.

Keyword

Varicose veins; Catheter ablation; Radiofrequency; Vein occlusion; Ultrasonography

MeSH Terms

Catheter Ablation
Catheters
Extremities
Female
Follow-Up Studies
Humans
Male
Outcome Assessment (Health Care)
Retrospective Studies
Saphenous Vein
Varicose Veins
Veins

Figure

• 

  Fig. 1 The measurement between the saphenous junction and leading point of occlusion. (A) Twelve months after radiofrequency ablation of great saphenous vein: The distance between the saphenous junction and leading point of occlusion was 1.63 cm. (B) Six months after ablation of small saphenous vein: a color Doppler image was used for measurement due to relatively deep position of vein. The distance was measured as 0.802 cm.

• 

  Fig. 2 Occlusion rate of saphenous vein. Kaplan-Meier analysis showed the similar occlusion rate between the great saphenous vein and small saphenous vein. GSV, great saphenous vein; SSV, small saphenous vein.

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  Fig. 3 Occlusion patterns of the great saphenous vein. This diagram showed 6 types of occlusion pattern of the great saphenous vein (GSV) after radiofrequency ablation. The most common type was total occlusion of GSV with patent inferior epigastric vein. CFV, common femoral vein; Epi, inferior epigastric vein; AL Br, anterolateral branch of GSV; P Br, patent branch; Br, branch.

• 

  Fig. 4 Occlusion patterns of the small saphenous vein. This diagram showed 5 types of occlusion pattern of the small saphenous vein (SSV) after radiofrequency ablation. The most common type was total occlusion of SSV with short patent stump. Pop. V, popliteal vein; SV, sural vein; CE, cranial extension of SSV; P Seg, patent segment; P Per, patent perforating vein.

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