Abstract
Introduction: Dilated & tortuous subcutaneous veins 3mm or more in diameter are known as varicose veins. When perforating veins become incompetent, it causes chronic venous insufficiency. Majority cases are managed conservatively. Cases with significant skin changes and ulcers, requires surgical procedures.
 Methods: A prospective comparative study of 30 patients of varicosities, divided into two groups, A and B according to CEAP classification were assessed for VCSS preoperatively. They underwent radiofrequency ablation (RFA) and subfascial endoscopic perforator surgery (SEPS) respectively and postoperative VCSS was calculated at follow up at 4 weeks. Collected data was assessed for the change in clinical severity of the disease and compared for the complications of both surgical methods.
 Results: The mean difference of pre op and post op VCSS in patient treated by RFA is 6.0 and the mean difference of pre op and post op VCSS in patient treated by SEPS is 5.4. Post RFA complications include pain (20%) and ecchymosis (13.3%). Paraesthesia and DVT was not noted. Post SEPS complications include pain (40%), ecchymosis (40%) and paresthesia (13.33%). DVT was not noted post SEPS. Only 1 case (6.66%) treated by SEPS developed recurrence post operatively. Conclusion: RFA and SEPS are two different approaches for varicosities, RFA being truncal therapy and SEPS for perforators, both are almost equally effective in context of postoperative hospital stay and improvement of VCSS; safe in terms of post op complications.
 Keywords: Radiofrequency ablation (RFA), Subfascial endoscopic perforator surgery (SEPS), venous clinical severity score (VCSS), varicose veins
Highlights
Dilated & tortuous subcutaneous veins 3mm or more in diameter are known as varicose veins
We have compared both Radiofrequency ablation radiofrequency ablation (RFA) and Subfascial endoscopic perforator surgery subfascial endoscopic perforator surgery (SEPS) with each other using Venous clinical severity score Venous Clinical Severity Score (VCSS) score to be measured preoperatively and postoperatively both and comparing the change in clinical severity of the disease and comparing the rate of complications involved in both the procedures
After 4 weeks of surgery, patients were followed up with Post op VCSS to compare the change in the clinical severity of the disease and post op venous doppler done at 4 weeks to check for any recurrences
Summary
Dilated & tortuous subcutaneous veins 3mm or more in diameter are known as varicose veins. Methods: A prospective comparative study of 30 patients of varicosities, divided into two groups, A and B according to CEAP classification were assessed for VCSS preoperatively They underwent radiofrequency ablation (RFA) and subfascial endoscopic perforator surgery (SEPS) respectively and postoperative VCSS was calculated at follow up at 4 weeks. Increase incidence of varicose veins has been found associated with aging and various other risk factors like long standing, parity, obesity and family history.[2,3] Valvular insufficiency and venous dilation are among the prominent aetiological factors of varicose veins.[4,5] In the present study, we have compared both Radiofrequency ablation RFA and Subfascial endoscopic perforator surgery SEPS with each other using Venous clinical severity score VCSS score to be measured preoperatively and postoperatively both and comparing the change in clinical severity of the disease and comparing the rate of complications involved in both the procedures. Healing rates and maintenance of healing for stasis ulceration after 5 years is 90% in normal functioning deep vein and 80% in patients with deep venous insufficiency.[8,9] Aim of this study was to compare the radiofrequency ablation (RFA) versus subfascial
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