title: Radiofrequency ablation of varicose veins improves venous clinical severity score despite failure of complete closure of the saphenous vein after 1 year.
abstract: OBJECTIVE
  Endovenous treatment is increasingly supplanting open surgery for the treatment of varicose veins. Among emerging endovenous techniques, radiofrequency ablation (RFA) with a ClosureFast catheter is popular in Korea. The objective of this study was to evaluate and compare the efficacy and patient-reported outcomes of RFA of varicose veins.
  
  
  METHODS
  This is a retrospective study of a prospectively registered database of patients who underwent RFA for varicose veins from 2012 to 2013 in St. Mary's Hospital in Seoul. Korea. Efficient ClosureFast RFA catheters (Medtronic, San Jose, CA, USA) were used. The techniques used for RFA of varicose veins were performed according to the manufacturer's recommendations. Duplex scans and venous clinical severity scores (VCSSs) were used to document treatment outcome and patient symptoms before and after the procedures. Treatment outcomes were estimated before the procedure and 3 months, 6 months, and 12 months after the procedure. Outcomes were analyzed by paired t test, chi-square test, or Fisher's exact test as well as by logistical regression.
  
  
  RESULTS
  A total of 117 patients were evaluated for 183 consecutive RFA procedures (183 limbs). The initial technical success was 97.3% (178/183). The estimated mean VCSS changed over time from 4.0 ± 1.67 at preprocedure to 0.6 ± 1.05, 0.5 ± 1.02, and 0.6 ± 1.14 at 3 months, 6 months, and 12 months after the procedure, respectively. The improved VCSS was maintained 1 year after the procedure (p < 0.001). Recanalization of the saphenous vein was detected in 20 limbs at the 1-year follow up. The treatment failure group also exhibited a significant decline in the VCSS between preprocedure and 12 months (4.8 ± 1.76 vs. 1.8 ± 2.04, p < 0.001). Specifically, in the treatment failure group, 65% of limbs with episodic recanalization (13/20) were reoccluded or recanalized without venous reflux at the 1-year follow up.
  
  
  CONCLUSIONS
  In this study, RFA of varicose veins had an initial success rate of 97.7% and a significantly improved patient VCSS at 1 year. Patients with episodic recanalization of the saphenous vein also exhibited an improved VCSS with favorable duplex findings at 1 year.
authors.affiliation: Department of Surgery, Division of Vascular and Transplant Surgery, The Catholic University of Korea College of Medicine, Suwon, South Korea.
authors.forename: Hyeong Yong
authors.initials: HY
authors.lastname: Jin
authors.affiliation: Department of Surgery, Division of Vascular and Transplant Surgery, The Catholic University of Korea College of Medicine, Suwon, South Korea.
authors.forename: Haeng Jin
authors.initials: HJ
authors.lastname: Ohe
authors.affiliation: Department of Surgery, Division of Vascular and Transplant Surgery, The Catholic University of Korea College of Medicine, Suwon, South Korea.
authors.forename: Jeong Kye
authors.initials: JK
authors.lastname: Hwang
authors.affiliation: Department of Surgery, Division of Vascular and Transplant Surgery, The Catholic University of Korea College of Medicine, Suwon, South Korea.
authors.forename: Sang Dong
authors.initials: SD
authors.lastname: Kim
authors.affiliation: Department of Surgery, Division of Vascular and Transplant Surgery, The Catholic University of Korea College of Medicine, Suwon, South Korea.
authors.forename: Jang Yong
authors.initials: JY
authors.lastname: Kim
authors.affiliation: Department of Surgery, Division of Vascular and Transplant Surgery, The Catholic University of Korea College of Medicine, Suwon, South Korea.
authors.forename: Sun Cheol
authors.initials: SC
authors.lastname: Park
authors.affiliation: Department of Surgery, Division of Vascular and Transplant Surgery, The Catholic University of Korea College of Medicine, Suwon, South Korea.
authors.forename: Ji Il
authors.initials: JI
authors.lastname: Kim
authors.affiliation: Department of Surgery, Division of Vascular and Transplant Surgery, The Catholic University of Korea College of Medicine, Suwon, South Korea. Electronic address: wonys@catholic.ac.kr.
authors.forename: Yong Sung
authors.initials: YS
authors.lastname: Won
authors.affiliation: Department of Surgery, Division of Vascular and Transplant Surgery, The Catholic University of Korea College of Medicine, Suwon, South Korea.
authors.forename: Sang Seob
authors.initials: SS
authors.lastname: Yun
authors.affiliation: Department of Surgery, Division of Vascular and Transplant Surgery, The Catholic University of Korea College of Medicine, Suwon, South Korea.
authors.forename: In Sung
authors.initials: IS
authors.lastname: Moon
mesh_terms: D000328:Adult; D000368:Aged; D017115:Catheter Ablation; D016208:Databases, Factual; D057510:Endovascular Procedures; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D063868:Patient Outcome Assessment; D012189:Retrospective Studies; D012501:Saphenous Vein / Q000601:surgery*; D012720:Severity of Illness Index; D016896:Treatment Outcome; D014648:Varicose Veins / Q000601:surgery*
keywords: catheter ablation; minimally invasive surgical procedures; quality of life; radiofrequency catheter ablation; varicose veins