Endovenous radiofrequency ablation of tributary veins reflux

BACKGROUND: Varicose veins can be treated, after the evaluation of the reflux characteristics, with open or endovascular approaches. Radiofrequency ablation (RFA) has been recently proposed for the treatment of axial reflux (saphenous veins) but has never been evaluated its role in the treatment of tributary varices. Aim of this study was to evaluate the efficacy of RFA in the ablation of tributary veins reflux. METHODS: We performed a two years multicenter open-label study between 1st May 2014 and 30th April 2016. A precise preoperative anatomical and hemodynamic mapping by Duplex ultrasound examination was performed. Patients with tributary varicose veins were included to receive radiofrequency procedures. The varicose tributary vein must have a diameter within the range 2-20 mm with a minimum length of the segment to be treated of 7 cm. RESULTS: Two hundred seventy-four patients with tributary varicose veins were treated. Two-hundred and one (73.36%) were females and 73 (26.64%) were males; mean age was 53 +/- 17. As for the Clinical Class (C) of the CEAP classification, 109 (39.78%) patients belonged to C2, 96 (35.04%) patients belonged to C3, 40 (14.60%) patients belonged to C4, 11 (4.01%) patients belonged to C5, and 18 (6.57%) belonged to C6 patients. The preoperative venous diameter showed a mean of 8 +/- 3 mm. At one year follow-up the vein diameter mean value was of 4.1 +/- 0.7 mm (P< 0.0001). Duplex ultrasound showed a venous occlusion rate of 100% at 1 year. No thrombotic complications were observed. Signs and symptoms improved in all patients. No recurrence was recorded within the time frame of the follow-up period. CONCLUSIONS: RFA of tributary varicosities seems to improve patients signs and symptoms with good cosmetic results and without particular complications.