Fate of great saphenous vein after radio-frequency ablation: detailed ultrasound imaging.
Radio-frequency ablation (RFA) of the great saphenous vein (GSV) is an endovascular alternative to stripping. To determine long-term effectiveness, the fate of GSV treated for valvular insufficiency with RFA was evaluated in detail with ultrasound imaging (US). One hundred lower extremities were examined with high-resolution color flow US, an average of 8 months after RFA treatment of an incompetent GSV. For every cm of the RFA-treated segment, the US observation was classified as follows: absent, occluded, or recanalized. Lengths of vein segments in each class were added and percentages of absent, occluded, or recanalized segments were calculated. Five groups were identified. Group I (n = 15): segment of treated GSV was absent. Group II (n = 4): segment of treated GSV was visualized and occluded (these vein segments had no flow and were shrunk and "fibrotic" or thrombosed without clear evidence of significant shrinkage). Group III (n = 1): segment of treated GSV was recanalized. Group IV (n = 27): segment of treated GSV was obstructed (absent or occluded). Group V (n = 53): segment of treated GSV was partially recanalized, on average being 53% absent, 32% occluded, and 15% recanalized. Maximum recanalization was 50% of treated segment. RFA was successful in obliterating all of the GSV treated segment in 46% of veins (groups I, 15%, plus II, 4%, plus IV, 27%) and obliterated more than half of the treated vein segment in 53% of the cases (group V). A dynamic process of recanalization and thrombosis warrants further evaluation to determine if and how a collateral network may develop.
Salles-Cunha
Sergio X
SX
Jobst Vascular Center, Toledo, OH 43606, USA. ssallescunha@jvc.org
Rajasinghe
Hiranya
H
Dosick
Steven M
SM
Gale
Steven S
SS
Seiwert
Andrew
A
Jones
Linda
L
Beebe
Hugh G
HG
Comerota
Anthony J
AJ
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D017115:Catheter Ablation; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D012039:Regional Blood Flow; D012501:Saphenous Vein / Q000000981:diagnostic imaging* / Q000503:physiopathology / Q000601:surgery*; D018615:Ultrasonography, Doppler, Color; D018616:Ultrasonography, Doppler, Duplex; D014689:Venous Insufficiency / Q000000981:diagnostic imaging / Q000503:physiopathology / Q000601:surgery*