Efficacy and safety of multiple treatments for small hepatocellular carcinoma: an updated systematic review and component network meta analysis.

To identify predictors of early complete ablation zone resolution (within 1 year) after radiofrequency ablation (RFA) for low-risk papillary thyroid microcarcinoma (PTMC). A retrospective dual-center study enrolled 225 patients with low-risk PTMC (2017-2022). Ablation zone volume was tracked during follow-up, with the specific time of complete resolution modeled using exponential decay functions. Multivariable Cox regression and restricted cubic spline (RCS) analyses identified independent predictors of resolution. Cumulative complete resolution rates were 62.2% at 1 year and 98.7% at 2 years. Independent predictors of complete resolution within 1 year included normal thyroglobulin antibody (TgAb) levels (hazard ratio (HR): 2.64, 95% confidence Interval (CI): 1.38-5.07) and thyroid peroxidase antibody (TPOAb) levels (HR: 1.92, 95% CI: 1.34-2.75), nodule diameter ≤ 5 mm (HR: 1.53, 95% CI: 1.02-2.29), and absence of intratumoral vascularity (HR: 2.77, 95% CI: 1.83-4.21). Energy density showed an inverted U-shaped relationship with resolution probability within 1 year (p < 0.001 for non-linearity). RFA achieves favorable long-term efficacy for low-risk PTMC, and complete resolution within 1 year is predictable by normal TgAb/TPOAb, smaller nodule size, absence of intratumoral vascularity, and moderate energy density. These findings may provide valuable insights for refining RFA techniques and the development of personalized follow-up. Question Predicting early complete resolution of low-risk PTMC after RFA is critical to mitigate concerns about treatment outcomes and optimize follow-up. Findings Normal TgAb/TPOAb, smaller nodule size, absence of intratumoral vascularity, and moderate energy density independently predict early complete ablation zone resolution within 1 year after RFA. Clinical relevance Identifying predictors of early resolution enables optimized RFA energy delivery and pretreatment decision-making. This provides doctors and patients with evidence-based guidance to refine ablation strategies and personalize management plans.

Frequent premature atrial complexes (PACs) can increase the risk of atrial fibrillation or atrial tachycardia, and pharmacological therapy can be challenging. To report the use of three-dimensional electro-anatomical mapping of PAC originating from the right atrial free wall and treatment by radiofrequency ablation in three horses. Retrospective case report. Frequent premature atrial complexes (PACs) were diagnosed in three horses. Twelve-lead ECG and vectorcardiography suggested an origin in the right lateral free wall in two horses and the caudal right atrium in one horse. Three-dimensional electro-anatomical mapping (3D EAM) and radiofrequency ablation using the CARTO™ 3 system were performed. Isoprenaline or dobutamine administration allowed activating the focus of PACs during general anaesthesia. Activation mapping using Pattern Matching Filtering identified the origin of PACs at the mid portion of the right atrial free wall in all horses. In the first horse, ablation was not performed due to pacing-induced phrenic nerve stimulation at the site of earliest activation. In the second horse, PACs disappeared after the 18th energy application and were no longer inducible by dobutamine. In the last horse, ablation was not successful in eliminating PACs. Small number of cases. The 3D EAM identified the focus of PACs at the right atrial free wall in three horses, revealing it as a possible arrhythmogenic area. Although still challenging, radiofrequency ablation has promise as a treatment to provide a permanent solution for frequent PACs.

Long-term outcomes of radiofrequency ablation versus surgery for bilateral multifocal (≤3) T1N0M0 papillary thyroid carcinoma: A retrospective cohort study.

This study aimed to assess the efficacy and safety of ultrasound-guided radiofrequency ablation (RFA) in elderly patients with primary hyperparathyroidism (PHPT). This retrospective cohort study included patients aged ≥ 60 years with PHPT who underwent ultrasound-guided RFA at a single center between May 2021 and May 2025. A total of 36 patients were analyzed. Laboratory parameters, including serum calcium and intact parathyroid hormone (iPTH), were assessed before and after the procedure. All patients were followed for at least 6 months. Cure was defined as normalization of both serum calcium and iPTH levels during follow-up. Procedural outcomes, complications, and factors associated with treatment response were evaluated. The mean age of the cohort was 70.4 (±8.69) years. After a single RFA session, 28 of 36 patients achieved a cure. When repeat procedures were included, the overall cure rate increased to 83.3% (30/36). The key procedure-related adverse events were postoperative mild pain and hoarseness. Hoarseness was transient in most cases; permanent hoarseness occurred in one patient. No major life-threatening complications were observed. Baseline characteristics did not differ significantly between cured and non-cured patients. Patients who developed hoarseness were older and had lower baseline magnesium levels than those without hoarseness. Ultrasound-guided RFA appears to be an effective and safe minimally invasive treatment option for selected elderly patients with PHPT, achieving acceptable cure rates with a favorable safety profile. RFA may represent a valuable alternative for elderly or frail patients who are at increased surgical risk. Prospective studies with larger cohorts and longer follow-up are warranted to confirm these findings.

Despite advancements in radiofrequency ablation (RFCA) technology and strategy, the long-term rhythm outcomes of persistent atrial fibrillation (PeAF) remain suboptimal. Since the vein of Marshall (VOM) is situated within the mitral isthmus (MI) area and covers local neural innervation and fiber networks, its pathophysiological role in mediating and maintaining atrial fibrillation (AF) and causing arrhythmia recurrence has garnered increasing attention. Ethanol infusion into the vein of Marshall (EIVOM) may complement RFCA by delivering anatomically targeted chemical injury along the VOM course, thereby facilitating contiguous MI lesion formation and durable MI block. We performed a narrative review of mechanistic, procedural, and clinical evidence regarding EIVOM in AF ablation, with emphasis on MI block, rhythm outcomes, technical limitations, complications, and its potential role in pulsed field ablation (PFA)-based workflows. Available evidence indicates that EIVOM facilitates durable MI block by targeting VOM-related epicardial connections and may improve rhythm outcomes when combined with RFCA in selected PeAF ablation strategies. Its clinical application is influenced by procedural and anatomical factors, while safety considerations and its potential complementary role in PFA-based workflows remain important areas for further evaluation. EIVOM is a promising adjunct to RFCA, particularly for facilitating durable MI block and reducing residual epicardial conduction. Further standardized multicenter studies are needed to refine patient selection, procedural integration, safety optimization, and its role in contemporary AF ablation.

Accurate survival prediction is paramount for selecting appropriate candidates for minimally invasive surgery (MIS) among patients with spinal metastases. Traditional scoring systems often neglect the host's systemic inflammatory response. This study aimed to develop a prognostic nomogram integrating the Glasgow Prognostic Score (GPS) and Lymphocyte-to-Monocyte Ratio (LMR) and evaluate its efficacy against the established Katagiri and SORG systems. A retrospective study was conducted on 172 patients who underwent MIS (percutaneous vertebroplasty and/or radiofrequency ablation) for spinal metastases. Patients were divided into training (n = 120) and testing (n = 52) cohorts. Independent prognostic factors were identified using multivariate Cox regression to construct a nomogram. Model performance was evaluated using Area Under the Curve (AUC), calibration plots, Decision Curve Analysis (DCA), Net Reclassification Improvement (NRI), and Integrated Discrimination Improvement (IDI). Multivariate analysis identified eight independent prognostic factors: clinical profile, surgical modality, systemic therapy, analgesic use, bone metastasis, visceral metastasis, LMR, and GPS. The new nomogram demonstrated excellent discrimination with 12-month AUCs of 0.886 (training) and 0.831 (testing), significantly outperforming the Katagiri (AUC 0.740) and SORG (AUC 0.710) systems (p < 0.001). Calibration plots revealed high agreement between predicted and observed survival. Furthermore, the new model showed significantly improved predictive accuracy over Katagiri (NRI 0.415; IDI 0.227) and SORG (NRI 0.391; IDI 0.289) at 12 months. A risk score cutoff of 2.09 effectively stratified patients into low- and high-risk groups (p < 0.001). By integrating objective inflammatory-nutritional markers with clinical factors, this novel nomogram provides enhanced survival prediction compared to traditional anatomical scoring systems. It serves as a robust tool for guiding personalized palliative decision-making in the era of modern systemic therapy.

Endoscopic ultrasound-guided radiofrequency ablation (EUS-RFA) is increasingly used; however, clinical application remains unstandardized. We assessed real-world practice among international users. A cross-sectional 70-item survey was conducted. Results are presented descriptively (numbers, percentages). Overall, 91 of 175 invited physicians from Europe (74.4%), North America (13.3%), and Asia (12.2%) completed the survey. EUS-RFA was performed by 94.1% of respondents for insulinoma, with heterogeneous responses for other indications. Most physicians (96.3%) performed EUS-RFA under deep sedation or general anesthesia; marked variability was reported on antibiotic prophylaxis (57.5%), aggressive hydration (52.5%), generator power settings, ablation strategy, or probe selection. Lesions involving or located ≤ 1 mm from the main pancreatic duct were considered high risk by 97.5% and 85.0%, respectively, yet no standardized preventive strategy was identified. Post-procedural management and follow-up were heterogeneous, with a high proportion of responses for definitions of technical success (88.8%), clinical success in insulinoma (92.3%), and disease recurrence (97.5%), with high variability for definitions of partial ablation and post-RFA pancreatitis. Despite the global expansion of EUS-RFA, clinical practice remains highly heterogeneous and geographically skewed. The lack of standardized methodology and terminology poses significant barriers to generating high-quality evidence.

Percutaneous vertebral augmentation is widely used to provide symptom relief for patients with painful vertebral compression fractures (VCFs), but adjacent fractures remain a known complication. This retrospective study evaluated the risk of adjacent vertebral fractures following different percutaneous vertebral augmentation techniques. A total of 985 encounters from 878 patients who underwent vertebroplasty, kyphoplasty, or bone tumor radiofrequency ablation (BT-RFA) with cement augmentation were included. The primary outcome was incidence of postprocedural adjacent fractures. Associations with demographic and clinical factors including age, sex, BMI, pathologic fractures, bone density, imaging guidance, and number of treated levels were assessed. Statistical analyses included a generalized linear mixed model and Cox proportional hazards models clustered by patient. Adjacent fracture occurred in 17.8% of encounters. BT-RFA was associated with a significantly lower risk of adjacent fractures compared with kyphoplasty (HR: 0.54, 95% CI:0.36-0.81; p = 0.003) and vertebroplasty (HR: 0.40, 95% CI: 0.27-0.60; p < 0.0001). Multilevel vertebral augmentations increased fracture risk by 1.42-fold, while pathologic fractures lowered the odds of adjacent fracture. No significant associations were found for age, BMI, sex, cement extravasation, or bone density. BT-RFA combined with cement augmentation significantly reduced the risk of adjacent fractures compared to kyphoplasty or vertebroplasty.

Genicular nerve radiofrequency ablation (RFA) efficacy for knee osteoarthritis (OA) remains debated. This prospective pilot study evaluated the feasibility and outcomes of a novel 5-nerve ultrasound-guided protocol targeting: Superior-Medial (SMGN), Superior-Lateral (SLGN), Inferior-Medial (IMGN), Inferior-Lateral (ILGN) Genicular Nerves and Recurrent Fibular Nerve (RFN). Nineteen patients were enrolled. Feasibility was assessed through protocol adherence and safety (adverse events rate). Primary outcomes were pain (Numerical Rating Scale - NRS) and function (Western Ontario and McMaster Universities Osteoarthritis Index - WOMAC) defining responders as ≥50% improvement. Secondary assessments included Environmental Quality of Life Scale (EQoL-5), 6-Minute Walk Test (6MWT), Timed-Up-and-Go (TUG), and Medical Research Council (MRC) scale at 1 and 3 months. Significant improvements occurred in NRS (p < 0.001), WOMAC (p < 0.001), and EQoL-Index (p = 0.003); responder rate was 63.2% (n = 12/19). One patient withdrew after T1 due to dissatisfaction; no study attrition or adverse events (notably motor deficits) occurred. Baseline 6MWT >200 m associated with treatment response (p = 0.048), though small sample size limits generalizability. This 5-nerve protocol demonstrated clinical plausibility and safety. Lack of a control group precludes definitive attribution of improvements to RFA over placebo. Robust RCTs comparing 3-nerve vs. 5-nerve protocols are mandatory before clinical implementation.

Breast cancer treatment is rapidly evolving toward precision-based de-escalation strategies for oncological safety and minimizing treatment-related morbidity. In early stage disease, minimally invasive approaches, such as non-surgical ablation techniques, including cryoablation and radiofrequency ablation, potentially constitute alternatives to conventional surgery for carefully selected low-risk tumors. Active surveillance trials challenge the necessity of immediate surgery for low-risk ductal carcinoma in situ, reflecting a paradigm shift toward risk-adapted management. In the neoadjuvant setting, achieving radiologic and pathologic complete responses, particularly in HER2-positive and triple-negative subtypes, is being investigated to determine the feasibility of omitting breast surgery under strict imaging and biopsy-guided protocols. Circulating tumor DNA-based minimal residual disease assays offer a promising tool for refining risk stratification and potentially guiding the extent of surgery and adjuvant therapy. These strategies represent a transformative movement toward biologically tailored, response-adapted, less invasive treatments for early breast cancer to optimize quality of life without compromising long-term outcomes.

Chronic pelvic pain in women is often multifactorial and associated with amarked impairment in quality of life. Among the most common structural causes are symptomatic uterine fibroids and pelvic congestion syndrome. This review provides an overview of interventional radiological treatment options for both conditions, with afocus on pain reduction and clinical effectiveness. Current reviews, meta-analyses, and clinical studies on uterine artery embolization (UAE), magnetic resonance (MR-)high-intensity focused ultrasound (HIFU), and radiofrequency and microwave ablation for the treatment of symptomatic uterine fibroids, as well as pelvic vein embolization for pelvic congestion syndrome, were summarized. In uterine fibroids, UAE, HIFU/MR-HIFU, and thermal ablation techniques improve symptoms and quality of life. UAE is particularly well established for multiple and large fibroids, whereas HIFU and thermal ablation techniques appear especially suitable for selected, more focal lesions. In pelvic congestion syndrome, meta-analyses demonstrate amarked and sustained reduction in pain following pelvic vein embolization. Interventional radiological procedures represent effective organ-preserving treatment options for both conditions. While the analgesic effect in pelvic congestion syndrome is usually demonstrated directly by pain scales, in fibroid therapies it is generally assessed only indirectly through symptom and quality-of-life parameters. Standardized assessment of pain could help to define patient-relevant benefit more clearly in future studies.

ObjectiveTo evaluate and compare the efficacy and safety of endoscopic neurectomy versus radiofrequency ablation targeting both the posterior nasal nerve (PNN) and lateral internal nasal branches of the anterior ethmoidal nerve (LINB-AEN) in patients with allergic rhinitis (AR).MethodsIn this prospective randomized controlled trial, adult patients with moderate to severe AR undergoing endoscopic nerve intervention from November 2023 to September 2025 were randomized to receive either neurectomy or ablation. Surgical targets included both PNN and LINB-AEN. Outcomes were assessed at 1, 3, and 6 months postoperatively and included nasal symptom visual analog scale (VAS), total nasal symptom score (TNSS), rhinoconjunctivitis quality of life questionnaire (RQLQ), total nasal resistance (TNR), olfactory function (VAS, QOD-NS, and Sniffin' Sticks), and adverse events.Results61 patients completed follow-up (neurectomy group: n = 30; ablation group: n = 31). Both groups achieved significant symptomatic improvement by 6 months (p < 0.001). The ablation group demonstrated significantly greater improvement in nasal obstruction (p < 0.001) and sneezing (p = 0.008) at 1 month, while the neurectomy group showed earlier improvement in rhinorrhea (p = 0.002). Both procedures improved nasal resistance. Neurectomy provided a faster, sustained nasal resistance improvement (p 3 months = 0.001, p 6 months = 0.003) with superior improvement in odor identification (p < 0.001) and TDI score (p = 0.005). Notably, no serious complications were reported. Additionally, symptoms of nasal dryness improved from baseline in both groups.ConclusionThis is the first randomized controlled study to compare dual-target endoscopic neurectomy and ablation for AR. Both approaches are effective and safe. Ablation offers faster symptom relief, while neurectomy provides superior long-term control of nasal airflow and olfactory function. Individualized surgical planning is recommended based on symptom profile and patient preference.Trial RegistrationChinese Clinical Trial Registry Identifier: ChiCTR2500111543Level of Evidence2.

Preeclampsia significantly contributes to maternal and perinatal morbidity and mortality, with twin pregnancies increasing this risk. Severe preeclampsia often requires pregnancy termination to protect maternal health. We report two cases of IVF-conceived twin pregnancies complicated by early preeclampsia. The first case involved a 34 year-old woman, gravida-2, abortion-1 at 21 weeks gestation with monochorionic twins, blood pressure of 150/80 mmHg, and proteinuria of 1600 mg. She underwent radiofrequency ablation of one twin at 22 weeks and delivered a healthy infant at 37 weeks. The second case involved a 34 year-old woman diagnosed with preeclampsia at 22 weeks, who experienced severe placental abruption in the third trimester, resulting in preterm delivery and a neonate admitted to the NICU. Selective fetal reduction may be a viable therapeutic option in managing twin pregnancies complicated by early severe preeclampsia. Such interventions should be performed with full maternal consent and a strong desire to continue the pregnancy.

Acute pericarditis is an uncommon complication of thermal atrial fibrillation (AF) ablation, whereas milder pericardial inflammatory symptoms, typically pleuritic or positional chest pain, are more common and negatively affect post-procedural recovery. Pulsed field ablation (PFA), a non-thermal modality with tissue-selective properties, may reduce collateral pericardial injury. We compared post-procedural pericardial inflammatory symptoms and recovery after AF ablation using PFA vs. radiofrequency ablation (RFA). This single-center observational study with prospective data collection included 150 patients undergoing catheter ablation for paroxysmal or persistent AF using focal PFA (n = 75) or RFA (n = 75). Patients were identified from the procedural workflow during the study period. Post-procedural pericardial inflammatory symptoms, chest pain severity (5-point scale), anti-inflammatory therapy use, length of hospital stay, and biomarkers of inflammation (CRP) and myocardial injury (hs-TnT) were assessed during hospitalization and structured post-discharge follow-up. Baseline characteristics were similar between groups. Post-procedural chest pain occurred more frequently after RFA than PFA (32% vs. 5.3%, p < 0.001), despite a significantly greater proportion of patients in the PFA group receiving lesion sets beyond pulmonary vein isolation (94.7% vs. 73.3%, p < 0.001). Anti-inflammatory therapy was prescribed more frequently after RFA (20% vs. 2.7%, p = 0.001), and hospital length of stay was longer [2 (1-2) vs. 1(1-1) days, p = 0.03). Procedure duration was shorter with PFA (86 ± 36 vs. 122 ± 55 min, p < 0.001). Median hs-TnT levels were higher after PFA [1288 (865-2137) vs. 1001 (652-1368] ng/L, p = 0.01), whereas CRP levels were similar [10.4 (4.9-23.3) vs. 10.5 (6.9-27.3) mg/L; p = 0.38]. PFA was associated with fewer post-procedural pericardial inflammatory symptoms, reduced need for anti-inflammatory therapy, and faster recovery compared with RFA. These findings suggest reduced pericardial irritation and improved patient-centered recovery after AF ablation.

Lumbar facet joint pain is a common cause of chronic low back pain and contributes substantially to physical disability, reduced functional capacity, and socioeconomic burden. Radiofrequency ablation (RFA) and steroid injection therapy are widely used interventional procedures for managing facet-mediated pain, yet their comparative effectiveness in routine clinical practice remains an area of ongoing investigation. To compare the clinical efficacy, functional outcomes, and duration of pain relief achieved with RFA versus steroid injection therapy in patients with lumbar facet joint pain. This prospective comparative study included 132 adult patients with lumbar facet joint pain diagnosed on clinical evaluation and confirmatory medial branch block. Patients were allocated into two groups: RFA group ( n = 66) and steroid injection group ( n = 66). Clinical outcomes were assessed using the Visual Analog Scale (VAS) for pain, Oswestry Disability Index (ODI) for function, and duration of pain relief over a 6-month follow-up period. Adverse events and the need for repeat interventions were also documented. Statistical analysis included paired and unpaired t -tests, Chi-square test, and repeated-measures analysis of variance, with P < 0.05 considered statistically significant. Both groups demonstrated significant short-term improvement in VAS and ODI scores; however, the RFA group showed greater reduction in pain intensity and functional disability at 3 and 6 months. The proportion of patients achieving sustained pain relief and the mean duration of clinically meaningful benefit were higher in the RFA group than in the steroid injection group. Minor transient complications were observed in both groups, with no major adverse events or procedure-related neurological deficits. RFA provides superior long-term pain relief and functional improvement compared with steroid injection therapy for lumbar facet joint pain. RFA may be considered a more durable and effective interventional option in patients with chronic facet-mediated lumbar pain.

Intrahepatic bile duct cystadenoma(IBC) is rare in clinic, and some patients can not tolerate or refuse surgical treatment.The clinical data of patients with IBC who underwent ultrasound-guided percutaneous sclerotherapy combined with radiofrequency ablation (RFA) in the First Affiliated Hospital of Zhengzhou University from January 2020 to November 2024 were retrospectively analyzed. A total of 11 patients were included, including 1 male and 10 females, aged from 35 to 73 years. All the 11 patients successfully completed the operation, and the postoperative complication rate was 36.4%, all of which were Clavien-Dindo grade Ⅰ. The median follow-up time was 36 months (range, 12-66 months), and the last follow-up date was December 1, 2025. One patient had recurrence one month after operation and was treated with ultrasound-guided sclerotherapy combined with RFA again. Up to the last follow-up, the patient had no recurrence or malignant transformation. There was no recurrence or malignant transformation in the remaining 10 patients.There were statistically significant differences in the volume of lesions between before operation and 1, 3, 6, 12 months after operation (all P<0.05), and there were statistically significant differences in the reduction rate of lesion volume between 1 month after operation and 3, 6, 12 months after operation (all P<0.05).This pilot study shows that ultrasound-guided sclerotherapy combined with RFA is safe and effective in the treatment of IBC.

Low back pain (LBP) is a leading cause of disability worldwide, and treatment often necessitates invasive interventions that carry significant risks and economic burdens. While prior studies demonstrated durable benefit following percutaneous 60-day peripheral nerve stimulation (PNS), real-world data are needed to characterize long-term outcomes across routine clinical practice. This survey evaluated the durability of patient-reported improvements among a real-world cohort of patients with LBP who responded to 60-day PNS. A cross-sectional follow-up survey was administered to patients who previously responded to 60-day PNS targeting the lumbar medial branch nerves. Outcomes assessed included patient-reported percent pain relief and impression of change in quality of life (QoL), physical function, mood, and sleep. Participants also reported use or avoidance of other LBP treatments or interventions since completing 60-day PNS. The survey was completed by 602 participants, with follow-up durations ranging from 6 to 68months. Overall, 79% (475/602) of participants required no radiofrequency ablation (RFA), permanent implant, or surgery following 60-day PNS. Among participants who avoided subsequent interventions, 79% (376/475) reported durable improvements in at least one domain (≥ 50% pain relief and/or clinically meaningful improvement of QoL, physical function, mood, and/or sleep) at follow-up. Among participants without a prior permanent neurostimulator implant, 92% (309/336) of those who sought to avoid permanent implantation succeeded. Among those without prior low back surgery who wanted to avoid it, 95% (353/370) avoided surgery through follow‑up. These findings suggest that patients with LBP who respond to percutaneous 60-day PNS may experience durable relief, with benefits sustained by some for 5+ years. Participants reported reductions in pain leading to improvements in other health domains, and avoidance of subsequent interventions, including surgery, permanent implants, and/or RFA, through long-term follow-up, highlighting the potential use of percutaneous 60-day PNS as a minimally invasive, short-term treatment capable of producing long-lasting benefits in patients with LBP.

Reconnection of the pulmonary veins (PVs) is the primary cause of atrial fibrillation (AF) episodes after pulmonary vein isolation (PVI). Cryoballoon ablation does not always include the isolation of the carina due to anatomic variants and carina width has been associated with increased re-ablation rate in previous radiofrequency ablation studies. Aim of our study was to assess the impact of carina width on the re-ablation rate after cryoballoon-PVI. We included 518 patients who underwent cryoballoon ablation for AF between 2015 and 2022. Each patient underwent contrast enhanced chest computed tomography (CT) scan prior to ablation. We measured the shortest distance between the superior and inferior PV (carina width) and the size of the left atrium in CT images. In patients referred to re-ablation due to recurring symptomatic and ECG documented AF we defined the reconnected veins. The minimum follow up after prior PVI was 1 year. In all patients the right carina was wider than the left (8.04 ± 4.49 mm vs. 5.25 ± 3.03 mm, p < 0.059). One fifth (n = 102) of the patients underwent re-ablation for AF. Left carina width was significantly associated with re-ablation rate (in re-ablation group 6.4 ± 2.7 mm vs. in no re-ablation group 4.9 ± 3.0 mm, p < 0.001) whereas right carina width was not (8.3 ± 3.0 mm vs. 7.9 ± 3.6 mm, p = 0.421, respectively). Left atrium (LA) was larger in the re-ablation group, but the size of the LA did not correlate with the left carina width (r = 0.075; p = 0.111). However, there was a significant correlation between the size of the LA and the width of the right carina (r = 0.251, p < 0.001). Also, in the re-ablation group a significant correlation between right carina width and reconnection of the right PV's (RPV) was detected, which was not seen in the left PV's (LPV) (p = 0.015; p = 0.360, respectively). The left carina width and LA size are associated with the success rate of primary cryoballoon-PVI. However, there was a correlation between the right carina width and the reconnection of the RPV's leading to re-ablation. It seems that recognition of anatomical variants could be useful in the decision of ablation technique, but further studies are needed.

This study aims to compare the clinical efficacy and safety of traditional open surgery and radiofrequency ablation in the treatment of great saphenous varicose veins. A total of 177 patients with great saphenous varicose veins admitted to our hospital between January 2023 and December 2024 were retrospectively selected. According to the treatment methods, they were divided into the traditional open surgery group (TG, n = 85) and the radiofrequency ablation group (RG, n = 92). The surgical-related indicators, postoperative pain severity, quality of life score, incidence of complications, clinical efficacy, and postoperative recovery were compared between the two groups. The RG exhibited shorter operative time, reduced intraoperative blood loss, smaller incision length, and shorter hospital stay compared with the TG (P < 0.05). The RG showed lower VAS pain scores at each time point after surgery than the TG (P < 0.05). At 1, 3, and 6 months after surgery, the AVVQ quality of life scores of the RG were lower than those of the TG (P < 0.05). The RG exhibited lower overall incidence of complications than the TG (P < 0.05). There was no statistically significant difference in the postoperative venous closure rate and recurrence rate between the two groups (P > 0.05). The RG exhibited shorter postoperative ambulation time, wound healing time, and compression stocking wearing time compared with the TG (P < 0.05). Bed charges, nursing fees, and medication costs were lower in the RG (P < 0.05). Radiofrequency ablation for great saphenous varicose veins is associated with several advantages, including reduced surgical trauma, faster recovery, less pain, and a lower incidence of complications. During the 6-month follow-up period, its clinical efficacy was comparable to that of the traditional open surgery, while showing potential advantages in cosmetic outcomes. Long-term efficacy requires further follow-up studies.