Real-world short-term VenaSeal ablation outcomes for symptomatic saphenous incompetence.

Abstract

Chronic venous insufficiency is a common vascular condition with significant resultant patient morbidity. There has been a shift towards minimally invasive treatment modalities with VenaSeal endovenous ablation among the more recent treatment modalities introduced. Long-term outcome data for this treatment modality is not widely available yet. We aim to report 6-week patient outcomes over a 5-year period from a high-volume tertiary vascular centre. This is a retrospective, single-centre study reporting short-term outcomes following VenaSeal endovenous ablation for symptomatic saphenous incompetence. Patients were followed-up at 6-weeks post-procedurally by telemedicine or in-person clinic appointment without routine venous ultrasound assessment. We report outcomes for 235 patients during this study period. All patients tolerated the procedure under local anaesthesia. Average age was 60.5years (29-82years) with slight male predominance (55.7%). The majority were New Zealand European (63.8%). Mean body mass index was 28.5 (22.2-41.4). We report a 21% rate of self-limiting phlebitis and 33 minor complication events. These include 15 cases of residual varicose veins, 9 saphenous nerve neuropraxia, 6 cases of puncture-site cellulitis and 3 deep vein thromboses. Patient demographics and primary surgeon did not have a statistically significant outcome on development of complications. We report that VenaSeal endovenous ablation is a safe and effective method of treatment for symptomatic truncal saphenous vein incompetence. We report safely managing post-operative phlebitis conservatively and find a mixture of clinical and phone clinic follow-up sufficient without requirement for objective duplex ultrasound following the procedure to ensure objective saphenous vein closure.