title: Thermal ablation of saphenous veins is feasible and safe in patients older than 75 years: A prospective study (EVTA study).
abstract: OBJECTIVE
  To investigate the tolerance and safety of thermal ablation (TA), consisting of radiofrequency or endovenous laser (EVLA) of saphenous veins (SV) in elderly (group 1 ≥75 years), compared with a control group (group 2 <75 years).
  
  
  METHODS
  An Observational multicenter-prospective study was conducted, under the aegis of the French and Swiss Societies of Phlebology (18 centers). Ninety patients were included in group 1, 617 in group 2 (mean age 80 years and 53 years; 69% women in both groups), representing 863 SV. Mean trunk diameters were similar in both groups (small SV: 6 mm; great SV: 7 mm). In group 1, comorbidities were more frequent, particularly cardiac insufficiency, diabetes, history of thrombosis, and CEAP clinical class was significantly higher.
  
  
  RESULTS
  EVLA was used in 86% of cases. Settings used were similar in both groups for each technique. Only 6% of TA was performed in an operating room for group 1 (14% group 2). Tumescent local anaesthesia (TLA) alone was used in 91% of cases in group 1 (85% group 2). The mean pain score was only 1.6 for the procedure itself (VASP 0-10; 10 max.) and 1.4 for the 10 days following the procedure. Side effects were few, but rate of paraesthesia was higher when general anaesthesia was used (11.8%) compared with TLA alone (2.2%). At three months, 100% of SV was occluded in group 1 (99.5% group 2), with high satisfaction score (9.3/10).
  
  
  CONCLUSIONS
  TA is safe and effective in elderly; it should be performed strictly under TLA to minimize side effects.
authors.affiliation: French Society of Phlebology, Paris, France claudine@desnos.eu.
authors.forename: C
authors.initials: C
authors.lastname: Hamel-Desnos
authors.affiliation: French Society of Phlebology, Paris, France.
authors.forename: P
authors.initials: P
authors.lastname: Desnos
authors.affiliation: Medical Evaluation Chair and Cenbiotech, Dijon, France.
authors.forename: F-A
authors.initials: FA
authors.lastname: Allaert
authors.affiliation: Private Office of Vascular Medicine and Service of Angiology, University Hospital Lausanne, Vevey, Switzerland.
authors.forename: P
authors.initials: P
authors.lastname: Kern
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D017115:Catheter Ablation / Q000009:adverse effects / Q000379:methods*; D005260:Female; D006801:Humans; D053685:Laser Therapy / Q000009:adverse effects / Q000379:methods*; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D012501:Saphenous Vein / Q000601:surgery*; D014689:Venous Insufficiency / Q000601:surgery*
keywords: Thermal ablation; elderly; paraesthesia; saphenous veins; tumescent local anaesthesia