Comparative Study on the Effectiveness and Safety of Simultaneous and Staged Bilateral Saphenous Vein Radiofrequency Ablation

Abstract

Chronic Venous Insufficiency (CVI) is a common condition affecting more than half of the general population, with approximately 20% of cases being bilateral. The high prevalence, diagnosis, and treatment costs, along with the negative impact on patients' quality of life, underscore its significance. This study evaluates the clinical outcomes, quality of life effects, and postoperative complications of simultaneous and staged bilateral radiofrequency ablation (RFA) in patients with bilateral CVI in the great saphenous vein (GSV) at CEAP stages 2-4. This retrospective study included 433 patients with bilateral CVI in the great saphenous vein (GSV) at CEAP stages 2-4, treated with RFA between January 2018 and December 2022. Patients were classified into two groups: Group 1 (n=257) underwent simultaneous bilateral RFA, and Group 2 (n=176) underwent staged bilateral RFA. Clinical outcomes and quality of life effects were evaluated using Venous Clinical Severity Score (VCSS), Aberdeen Varicose Vein Questionnaire (AVVQ), and Visual Analog Scale (VAS) scores. Demographic data, type of anesthesia, surgery durations and postoperative complications were analyzed. Both groups showed significant improvements in AVVQ and VCSS scores at 12 months postoperatively, with no significant differences between the groups in preoperative and postoperative scores. No significant difference was found in postoperative VAS scores. Postoperative complication rates were low and comparable. No pulmonary embolism was observed. Symptomatic DVT was detected in one patient from each group and treated successfully. Simultaneous bilateral RFA is as effective and safe as staged bilateral RFA for treating CVI, providing similar clinical outcomes and low complication rates. The simultaneous approach offers the advantage of a single treatment session, potentially improving patient satisfaction and operational efficiency. This study supports simultaneous bilateral RFA as a viable and effective option for treating bilateral CVI.