Radiofrequency ablation (VNUS closure) does not cause neo-vascularisation at the groin at one year: results of a case controlled study.
BACKGROUND
Despite adequate training in the surgical treatment of varicose veins, recurrence continues to be a problem and a burden to the vascular services. A major cause of recurrence is reported to be neo-vascularisation at the sapheno-femoral junction (SFJ). The aim of this study was to compare the incidence of neo-vascularisation at the SFJ following radiofrequency ablation (RFA) and open high saphenous tie and stripping (HSTS).


METHODS
Fifty-one patients (55 legs) underwent standardised HSTS as part of a prospective study. These were compared with an age (range 28-83, mean 54.4) and sex (male:female 31:20) matched group of patients treated during the same time period, by the same consultant vascular surgeon, using RFA (VNUS closure). Each patient had a pre-operative duplex scan to confirm SFJ reflux, a one-week scan to confirm successful surgery and a one-year post-operative scan to assess neo-vascularisation. The same vascular technologist performed all scans. Neo-vascularisation was identified by the presence of refluxing tortuous vessels arising from the area of the SFJ.


CONCLUSIONS
Six of 55 (11%) legs in the open surgery group showed clear evidence of tortuous refluxing veins related to the SFJ. None of the 55 in the RFA group showed any neo-vascularisation at the SFJ (Fischer exact test P = 0.028). Further randomised controlled trials are necessary to confirm these observations.
Kianifard
B
B
The Royal Surrey County Hospital, Guildford, UK.
Holdstock
J M
JM
Whiteley
M S
MS
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D016022:Case-Control Studies; D017115:Catheter Ablation; D005260:Female; D006119:Groin; D006801:Humans; D015994:Incidence; D008297:Male; D016555:Matched-Pair Analysis; D008875:Middle Aged; D009389:Neovascularization, Pathologic / Q000453:epidemiology* / Q000517:prevention & control; D011183:Postoperative Complications / Q000453:epidemiology* / Q000517:prevention & control; D011446:Prospective Studies; D012008:Recurrence; D006113:United Kingdom / Q000453:epidemiology; D014648:Varicose Veins / Q000601:surgery*