In a recent study published in the Journal of Vascular Surgery – Venous and Lymphatic Disorders, Domenico Baccellieri, Vincenzo Ardita, Alfonso Pannone, Ferdinando B.A. Valente, Rosalba Lembo, Roberto Chiesa, and Germano Melissano delve into the long-term results of RFA for the great saphenous vein (GSV) and identify the risk factors associated with GSV recanalization and recurrent varicose veins (RVVs).
Examining RFA Outcomes
The study retrospectively analyzed data from 1300 consecutive patients who underwent RFA for incompetent GSVs between 2009 and 2019. Key objectives included assessing freedom from GSV recanalization and RVV rates during follow-up. The study also investigated postoperative complications and potential risk factors for GSV recanalization and RVVs.
Promising Durability and Safety
Among 1568 treated limbs, technical success was achieved in 99.7% of cases. Results at a mean follow-up of 57.2 ± 25.4 months revealed GSV occlusion and freedom from reintervention rates of 100% within 1 week, 97% and 95.7% at 1 year, 95.2% and 93.1% at 3 years, and 92.4% and 92.8% at 5 years, respectively. The recurrence rate stood at 10% during the follow-up period.
Identifying Risk Factors
The study’s multivariate analysis identified several risk factors for GSV recanalization and RVVs. These include a direct confluence of the accessory saphenous vein into the saphenofemoral junction, a history of pregnancy >2, C4 clinical classification, and a preoperative GSV diameter >10 mm as risk factors for GSV recanalization. Age >70 years and the presence of incompetent perforator veins were also risk factors for RVVs.
Conclusions
RFA was shown to be a safe and durable technique for GSV ablation during five years of follow-up. However, patients with a high clinical score and specific anatomical factors, such as direct confluence of the accessory saphenous vein, experienced higher rates of GSV recanalization and RVVs in the long term.
For a comprehensive review of the study, access the publication here.
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