Women Benefit From Endovenous Ablation With Fewer Complications: Analysis of the Vascular Quality Initiative Varicose Vein Registry

Abstract

We evaluated the association between gender and long-term clinical outcomes after endovenous ablation procedures. Using data from the Vascular Quality Initiative from 2015 to 2019, we identified patients who had undergone endovenous ablation procedures on truncal veins with or without treatment of perforating veins. We excluded patients with preoperative CEAP (clinical, etiologic, anatomic, physiologic) class <2. We used univariate analysis to determine the preprocedure, postprocedure, and periprocedural changes in the Venous Clinical Severity Score (VCSS) stratified by gender. We also determined the rates of deep vein thrombosis, leg pigmentation, blistering, paresthesia, incisional infection, and any postprocedural complications for each gender. We then used multivariate linear regression to examine how gender affects the relationships between the periprocedural change in the VCSS, patient characteristics, and complication rates. A total of 9743 patients were included in the present study. The women had lower pre- and postprocedural VCSSs, but both genders had similar a periprocedural change in the VCSS (Table). The women had a lower incidence of any postprocedural leg complications, blistering, deep vein thrombosis, and paresthesia. The men had lower incidence of leg pigmentation. Women with deep reflux experienced greater benefit from endovenous ablation than did men with deep reflux (Fig). At the extremes of body mass index (<25 and >35 kg/m2), women experienced greater benefit from endovenous ablation than did men. Women after endovenous ablation experienced improvements similar to those of men in the VCSS but with a lower incidence of postprocedural complications. Of those with deep venous reflux and at the extremes of body mass index, women were more likely to benefit from endovenous ablation than were men. These data are useful in predicting the results after venous ablation.TablePre- and postprocedure VCSS and periprocedural change in VCSS stratified by genderVariableMen (n = 3090)Women (n = 6653)P valueVCSS Preprocedure8.84 ± 4.107.54 ± 3.11<.001 Postprocedure4.47 ± 4.093.50 ± 3.23<.001 Change−4.46 ± 3.73−4.13 ± 3.23.001Complication, % Any leg complication8.66.10.001 Leg blistering0.60.40.2 Deep vein thrombosis1.10.60.06 Paresthesia1.91.70.5 Leg pigmentation0.30.70.1 Leg infection0.70.40.07VCSS, Venous clinical severity score.Data presented as mean ± standard deviation, unless noted otherwise. Open table in a new tab