Meta-analysis of endovenous radiofrequency obliteration of the great saphenous vein in primary varicosis.
OBJECTIVE
To compare radiofrequency obliteration (RFO) and conventional surgery with respect to postoperative complications, effectiveness of treatment, and quality of life (QoL).


METHODS
Several healthcare databases were interrogated to identify all studies published between 1994 and 2007 comparing RFO in primary varicosis to conventional therapy with vein ligation and stripping. Of 65 articles identified, 8 studies representing 428 patients [224 (52%) endovenous RFO and 204 (48%) stripping] were eligible for the meta-analysis. Adverse events, effectiveness, and QoL outcomes were assessed at several time points up to 2 years.


RESULTS
There were significant reductions in tenderness and ecchymosis at 1 week and significantly fewer hematomas at 72 hours, 1 week, and 3 weeks associated with RFO. There was no significant difference between the RFO and surgery in immediate or complete great saphenous vein (GSV) occlusion, incomplete GSV closure, freedom from reflux, recurrent varicose veins, recanalization, or neovascularization. QoL results significantly favoring RFO over surgery included return to normal activity and return to work.


CONCLUSIONS
It seems that RFO benefits most patients in the short term, but rates of recanalization, re-treatment, occlusion, and reflux may alter with longer follow-up. The lack of such data demonstrates the need for further randomized clinical trials of RFO versus conventional surgery.
Luebke
Thomas
T
Division of Vascular Surgery, University of Cologne, Germany.
Gawenda
Michael
M
Heckenkamp
Joerg
J
Brunkwall
Jan
J
D017115:Catheter Ablation / Q000379:methods*; D006801:Humans; D011183:Postoperative Complications; D011788:Quality of Life; D012501:Saphenous Vein / Q000601:surgery*; D014648:Varicose Veins / Q000601:surgery*