Value of radiofrequency ablation for perforating venous reflux / 中华普通外科杂志

ABSTRACT

Objective:To assess the value of radiofrequency ablation versus sclerotherapy for perforating venous reflux in the treatment of venous ulceration.Methods:This study included 56 patients with venous ulceration (C5/C6, 56 limbs) treated at Peking Union Medical College Hospital in 2018. The patients underwent radiofrequency ablation (Group A, 30 patients) or sclerotherapy (Group B, 26 patients) of perforating venous reflux.Results:The immediate success rate was 100%. During 1 to 12-month follow-up, 5 patients (1 in Group A and 4 in Group B) had recurrent venous ulcers. Recanalization of perforating veins was found in 8 patients (2 in Group A and 6 in Group B). The rates of free from venous ulcer′s recurrence in Group A and Group B were 92.6%±5.1% and 82.7%±8.0%, respectively. The rates of free from perforating vein recanalization were 88.4%±6.3 % and 61.5%±11.2% in Group A and Group B respectively. Univariate analysis of postoperative venous recanalization and ulceration recurrence revealed significant correlation between operation methods, perforating vein diameter and occurrence of adverse events. Specifically, radiofrequency ablation is associated with better outcome than sclerotherapy ( P=0.016), and perforating veins with diameter less than 3.5mm is associated with better outcome than those with diameter≥3.5mm( P=0.048). By multivariate regression analysis , operation type was the only risk factor of poor prognosis ( P=0.040). Conclusion:Radiofrequency ablation of perforating veins resulted in reduced rates of mid-term recanalization and ulceration recurrence compared with ultrasound-guided sclerotherapy.