Comparative analysis of the effectiveness of thermal methods for the treatment of varicose veins of the lower extremities

Abstract

The aim of the work is to analyze the effectiveness and safety of thermal methods (endovenous laser coagulation (EVLC) and radiofrequency ablation (RFA)) for the treatment of varicose veins of the lower extremities and the impact on the quality of patient life. Materials and methods. An open, prospective study of the comparative efficacy of EVLC (124 patients) and RFA (112 patients) for the treatment of patients with varicose vein disease was conducted. Both groups were compared by age, sex, body mass index, clinical manifestations of the venous pathology severity and assessed the risk of potential complications. Determination of quality of life criteria was performed using the AVVQ questionnaire. Results. The average number of cycles performed for the RFA procedure was 13.8 (7; 14), and the energy was 60.1 (8; 80) J/cm for EVLC. The average value of the VAS during the first 14 days after treatment in the EVLC group was 2.2 (sd 1.9), RFA – 0.8 (sd 0.9), P > 0.05. The majority of patients who underwent EVLC used painkillers – 82 (66.1 %), RFA – 48 (42.9 %), P < 0.001. The results of duplex monitoring in the first 48 hours recorded 100 % occlusion of the treated segments of the great saphenous vein in both study groups; after 1 and 12 months – in 98.4 % (96.0 %) of patients after EVLC and in 100.0 % (98.2 %) – after RFA, respectively. One or more adverse events during the first 2 weeks after treatment were reported by 86 patients (69.4 %) in EVLC group, 52 (46.4 %) – in RFA group. The differences between EVLC and RFA were statistically significant (P < 0.001). VCSS and AVVQ values were significantly decreased one month after treatment, continuing the positive trend for up to 12 months. However, no significant difference between ablation methods was observed (P > 0.05). Conclusions. Endovenous laser coagulation and radiofrequency ablation are safe and effective thermal treatments for varicose veins of the lower extremities, which lead to a statistically significant improvement in the quality of patient life. Radiofrequency ablation has the advantage of a lower risk of developing general complications.