Radiofrequency endogenous ablation and concomitant sclerotherapy

Abstract

Background Varicose veins are a widespread disease with various treatment modalities ranging from classic saphenofemoral crossectomy and ligation and stripping to various minimally invasive interventional procedures. The era of endovenous interventions has now stabilized head to head in results with surgical procedures, hence the shift to minimally invasive procedures. All minimal invasive endovenous procedures have excellent results, particularly when correctly selected according to the varicose vein case and the treated vein. Thermal ablation techniques are now established and have reliable and satisfactory outcomes, yet nonthermal techniques have offered further options. This article provides a novel approach combining the usage of radiofrequency endovenous ablation (RFA) simultaneously with transcatheter and transsheath ultrasound-guided foam sclerotherapy. Patients and methods We enrolled 50 patients with Duplex-confirmed primary varicose vein who had RFA and concomitant sclerotherapy. All patients were followed up by Duplex 1 week later and at 1- and 6-month intervals. Results In our study, we enrolled 50 patients, comprising 33 males and 17 females. Mean age was 45.36 years. The most frequent symptoms were pain (42%), swelling (28%), and fatigue (30%). Vein diameters ranged from 6 to 12 mm. Superficial thrombophlebitis in three patients was managed successfully by Clexane. One case developed endovenous heat-induced thrombosis (EHIT) and was treated by new oral anti coagulant (NOAC) Duplex assessment. All cases remained closed by Duplex at month, with vein ablation seen by the Duplex. The case with EHIT resolved ultimately on NOAC at 3 months, and the case of superficial thrombophlebitis at 1 month revealed adequate recanalization and relief of symptoms. Only one patient mentioned nonconvenient results, not meeting her expectations. Conclusion Combining foam sclerotherapy and RFA seems a safe and effective modality and should be explored in further studies.