Secondary Ablation of Recanalized Saphenous Vein after Endovenous Thermal Ablation

Abstract

To describe the occlusion rate and clinical response of a redo ablative procedure in symptomatic patients with recanalization of saphenous vein after endovascular thermal ablation. A retrospective cohort study was performed in a prospectively collected data of symptomatic patients with recanalization of the great saphenous vein (GSV) or small saphenous vein (SSV) after endovascular thermal ablation who underwent a secondary ablation (SA) from June 2015 to May2018. Ten patients (15 limbs) with recanalization of the GSV or SSV were treated with SA. The median age was 67years and 60% were men. The median time from the first ablation was 7.3years (interquartile range [IQR] 6.5-9.6). For SA, radiofrequency ablation was performed in 12 limbs (80%) and ultrasound-guided foam sclerotherapy in 3 cases (20%). The GSV was the treated vessel in 14 cases (93.3%). No complications were reported. Median follow-up was 13months. Preoperative and 1-year follow-up Venous Clinical Severity Score was 9 (IQR 5-10) and 4 (IQR 2-8), respectively. Duplex ultrasound evaluation after 1year showed an occlusion rate of 93.3% evidencing a partially recanalized vein in 1 treated limb. In this study, the occlusion rate was 93.3% at 1 year after SA; clinical improvement and no complications were reported. SA appears to be a valid option for the treatment of symptomatic patients with recanalized GSV or SSV.