title: Radiofrequency ablation: an assessment of clinical and cost efficacy.
abstract: BACKGROUND
  Varicose veins are common and frequently cause patient distress. In recent years, Radiofrequency ablation (RFA) has emerged as a minimally invasive alternative to traditional open venous ligation surgery.
  
  
  OBJECTIVE
  The aim of this study was to directly compare RFA and open saphenofemoral ligation.
  
  
  METHODS
  This was a single-centre retrospective cohort study. Consecutive patients undergoing surgical management over a 2-year period commencing from January 2011 were studied. Radiological success, peri-operative serological testing and hospital length of stay were documented. Procedural cost was calculated. A focused cohort analysis was undertaken to compare the initial 50 RFA procedures performed with the last 50.
  
  
  RESULTS
  During the study period, 296 patients underwent surgical intervention. A total of 204 patients underwent RFA. Sixty-six percent of all patients were female. RFA was associated with a reduction in overnight hospital stay (18 vs. 78 %, P = <0.001) when compared with open ligation with a success rate of 98 %. No significant inter-group difference was noted for 30-day readmission (p = 0.203). Focused cohort analysis identified an increase in hospital day case activity (74 vs. 90 %, p = 0.002), which contributed to a reduction in procedural cost (€1,024 vs. €971, p = 0.003) over the study period.
  
  
  CONCLUSIONS
  Radiofrequency ablation is a viable alternative to open repair offering excellent efficacy. It is however associated with a higher procedural cost than the open surgical option.
authors.affiliation: Department of Vascular Surgery, Beaumont Hospital, Beaumont Road, Dublin 9, Ireland. thomasaherne@rcsi.ie.
authors.forename: T
authors.initials: T
authors.lastname: Aherne
authors.affiliation: Department of Vascular Surgery, Beaumont Hospital, Beaumont Road, Dublin 9, Ireland.
authors.forename: S M
authors.initials: SM
authors.lastname: McHugh
authors.affiliation: Department of Vascular Surgery, Beaumont Hospital, Beaumont Road, Dublin 9, Ireland.
authors.forename: W
authors.initials: W
authors.lastname: Tashkandi
authors.affiliation: Department of Vascular Surgery, Beaumont Hospital, Beaumont Road, Dublin 9, Ireland.
authors.forename: J
authors.initials: J
authors.lastname: Byrne
authors.affiliation: Department of Vascular Surgery, Beaumont Hospital, Beaumont Road, Dublin 9, Ireland.
authors.forename: Y
authors.initials: Y
authors.lastname: Aljabi
authors.affiliation: Department of Vascular Surgery, Beaumont Hospital, Beaumont Road, Dublin 9, Ireland.
authors.forename: D
authors.initials: D
authors.lastname: Moneley
authors.affiliation: Department of Vascular Surgery, Beaumont Hospital, Beaumont Road, Dublin 9, Ireland.
authors.forename: A
authors.initials: A
authors.lastname: Leahy
authors.affiliation: Department of Vascular Surgery, Beaumont Hospital, Beaumont Road, Dublin 9, Ireland.
authors.forename: P
authors.initials: P
authors.lastname: Naughton
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D017115:Catheter Ablation / Q000191:economics* / Q000379:methods*; D015331:Cohort Studies; D003362:Cost-Benefit Analysis; D005260:Female; D006801:Humans; D008026:Ligation / Q000191:economics; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies; D012501:Saphenous Vein / Q000601:surgery*; D015911:Sclerotherapy / Q000191:economics / Q000379:methods; D014648:Varicose Veins / Q000601:surgery*; D014689:Venous Insufficiency / Q000601:surgery*
keywords: Radiofrequency catheter ablation; Surgery; Varicose veins