title: Randomized trial of radiofrequency ablation versus conventional surgery for superficial venous insufficiency: if you don't tell, they won't know.
abstract: This study compared radiofrequency ablation versus conventional surgery in patients who had not undergone previous treatment for bilateral great saphenous vein insufficiency, with each patient serving as his own control.
  This was a randomized controlled trial that included 18 patients and was carried out between November 2013 and May 2015. Each of the lower limbs of each patient was randomly assigned to undergo either radiofrequency ablation or conventional surgery. Clinical features (hyperpigmentation, hematoma, aesthetics, pain, skin burn, nerve injury, and thrombophlebitis) were evaluated at one week, one month, and six months postoperatively. Hemodynamic assessments (presence of resection or occlusion of the great saphenous vein and recurrent reflux in the sapheno-femoral junction and in the great saphenous vein) were performed at one month, six months, and 12 months postoperatively. The independent observer (a physician not involved in the original operation), patient, and duplex ultrasonographer were not made aware of the treatment done in each case. Clinicaltrials.gov: NCT02588911.
  Among the clinical variables analyzed, only the aesthetic evaluation by the physicians was significant, with radiofrequency ablation being considered better than conventional surgery (average, 0.91 points higher: standard deviation: 0.31; 95% confidence interval: -1.51, -0.30; p=0.003). However, in our study, we observed primary success rates of 80% for radiofrequency ablation and 100% for conventional surgery.
  If the physician is not required to inform the patient as to the technique being performed, the patient will not be able to identify the technique based on the signs and symptoms. Our study revealed that both techniques led to high levels of patient satisfaction, but our results favor the choice of conventional surgery over radiofrequency ablation, as patients who underwent conventional surgery had better hemodynamic assessments.
authors.affiliation: Hospital Israelita Albert Einstein, Division of Vascular and Endovascular Surgery, São Paulo/SP, Brazil.|Hospital Municipal Dr. Moysés Deutsch - M'Boi Mirim, São Paulo/SP, Brazil.
authors.forename: Cynthia de Almeida
authors.initials: CA
authors.lastname: Mendes
authors.affiliation: Hospital Israelita Albert Einstein, Division of Vascular and Endovascular Surgery, São Paulo/SP, Brazil.|Hospital Municipal Dr. Moysés Deutsch - M'Boi Mirim, São Paulo/SP, Brazil.
authors.forename: Alexandre de Arruda
authors.initials: AA
authors.lastname: Martins
authors.affiliation: Hospital Israelita Albert Einstein, Division of Vascular and Endovascular Surgery, São Paulo/SP, Brazil.
authors.forename: Juliana Maria
authors.initials: JM
authors.lastname: Fukuda
authors.affiliation: Hospital Israelita Albert Einstein, Division of Vascular and Endovascular Surgery, São Paulo/SP, Brazil.
authors.forename: José Ben-Hur Ferraz
authors.initials: JB
authors.lastname: Parente
authors.affiliation: Hospital Israelita Albert Einstein, Division of Vascular and Endovascular Surgery, São Paulo/SP, Brazil.
authors.forename: Marco Antonio Soares
authors.initials: MA
authors.lastname: Munia
authors.affiliation: Hospital Israelita Albert Einstein, Division of Vascular and Endovascular Surgery, São Paulo/SP, Brazil.|Irmandade da Santa Casa de Misericórdia de São Paulo, Division of Vascular and Endovascular Surgery, São Paulo/SP, Brazil.
authors.forename: Alexandre
authors.initials: A
authors.lastname: Fioranelli
authors.affiliation: Hospital Israelita Albert Einstein, Division of Vascular and Endovascular Surgery, São Paulo/SP, Brazil.
authors.forename: Marcelo Passos
authors.initials: MP
authors.lastname: Teivelis
authors.affiliation: Hospital Israelita Albert Einstein, Division of Vascular and Endovascular Surgery, São Paulo/SP, Brazil.
authors.forename: Andrea Yasbek Monteiro
authors.initials: AY
authors.lastname: Varella
authors.affiliation: Irmandade da Santa Casa de Misericórdia de São Paulo, Division of Vascular and Endovascular Surgery, São Paulo/SP, Brazil.
authors.forename: Roberto Augusto
authors.initials: RA
authors.lastname: Caffaro
authors.affiliation: Hospital Israelita Albert Einstein, Division of Vascular and Endovascular Surgery, São Paulo/SP, Brazil.
authors.forename: Sergio
authors.initials: S
authors.lastname: Kuzniec
authors.affiliation: Hospital Israelita Albert Einstein, Division of Vascular and Endovascular Surgery, São Paulo/SP, Brazil.
authors.forename: Nelson
authors.initials: N
authors.lastname: Wolosker
mesh_terms: D000293:Adolescent; D000328:Adult; D017115:Catheter Ablation / Q000009:adverse effects / Q000379:methods*; D005260:Female; D005268:Femoral Vein / Q000601:surgery; D006801:Humans; D053685:Laser Therapy / Q000379:methods*; D007866:Leg / Q000098:blood supply*; D008297:Male; D008875:Middle Aged; D011183:Postoperative Complications; D012501:Saphenous Vein / Q000000981:diagnostic imaging / Q000601:surgery*; D016896:Treatment Outcome; D018616:Ultrasonography, Doppler, Duplex; D014648:Varicose Veins / Q000601:surgery; D014689:Venous Insufficiency / Q000601:surgery*; D020246:Venous Thrombosis / Q000601:surgery*; D055815:Young Adult