Editor's Choice - Role of Compression After Radiofrequency Ablation of Varicose Veins: A Randomised Controlled Trial

Abstract

This randomized controlled trial of 100 consecutive patients with symptomatic venous insufficiency underwent RFA for mostly C3 to C4 disease. Randomization was done at the end of the procedures, 80% had RFA of saphenous veins, with patients opening a sealed envelope. Patients who wore compression stockings following radiofrequency ablation (RFA) did not have better outcomes than those who did not wear compression. Class 2 (23-32 mm Hg) compression was applied to the compression cohort who wore the hose for 2 weeks. Multiple satisfaction questionnaires were completed by all participants. At 12 weeks, there were no differences in occlusion rates (98% both groups), mean Aberdeen Varicose Vein Severity Scores and Revised Venous Clinical Severity Scores, satisfaction and pain scores, and deep venous thrombosis events. Although this relatively small clinical trial showed that there was no added benefit to compression following RFA for venous insufficiency, it is interesting that compression was only worn for 2 weeks. It is good to know that patients who cannot tolerate compression or in whom lighter compression is used will not have decreased occlusion rates as a result. But we also know that recanalization is not always accompanied by recurrent symptoms. My take home message is not to decline treatment to a patient who cannot tolerate long-term compression.