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Editor's Choice - Role of Compression After Radiofrequency Ablation of Varicose Veins: A Randomised Controlled Trial☆.
Onwudike, Madu; Abbas, Kazim; Thompson, Paula; McElvenny, Damien M.
  • Onwudike M; Vascular Surgery, Manchester University NHS Foundation Trust, Manchester, UK; Vascular Surgery, Bolton Hospitals NHS Foundation Trust, Bolton, UK. Electronic address: madu@doctors.org.uk.
  • Abbas K; Vascular Surgery, Manchester University NHS Foundation Trust, Manchester, UK.
  • Thompson P; Vascular Surgery, Bolton Hospitals NHS Foundation Trust, Bolton, UK.
  • McElvenny DM; Division of Population Health, Health Services Research & Primary Care, University of Manchester, UK.
Eur J Vasc Endovasc Surg ; 60(1): 108-117, 2020 Jul.
Article in English | MEDLINE | ID: covidwho-1454123
Semantic information from SemMedBD (by NLM)
1. Varicose vein operation PRECEDES Radiofrequency Ablation
Subject
Varicose vein operation
Predicate
PRECEDES
Object
Radiofrequency Ablation
2. Radiofrequency Ablation USES Compression Stockings
Subject
Radiofrequency Ablation
Predicate
USES
Object
Compression Stockings
3. Veins LOCATION_OF Complete obstruction
Subject
Veins
Predicate
LOCATION_OF
Object
Complete obstruction
4. Deep Vein Thrombosis PROCESS_OF Patients
Subject
Deep Vein Thrombosis
Predicate
PROCESS_OF
Object
Patients
5. Varicose vein operation PRECEDES Radiofrequency Ablation
Subject
Varicose vein operation
Predicate
PRECEDES
Object
Radiofrequency Ablation
6. Radiofrequency Ablation USES Compression Stockings
Subject
Radiofrequency Ablation
Predicate
USES
Object
Compression Stockings
7. Veins LOCATION_OF Complete obstruction
Subject
Veins
Predicate
LOCATION_OF
Object
Complete obstruction
8. Deep Vein Thrombosis PROCESS_OF Patients
Subject
Deep Vein Thrombosis
Predicate
PROCESS_OF
Object
Patients
ABSTRACT

OBJECTIVE:

Post-procedure limb compression, hitherto routine following open varicose vein surgery, has been extended to endovenous procedures. However, no robust evidence exists to support this practice. Most of the previous studies have focused on the ideal duration of compression. This study evaluates the clinical and patient reported outcomes with and without post-procedure leg compression following radiofrequency ablation (RFA).

METHODS:

This single centre, prospective, non-inferiority randomised controlled trial recruited adult patients, into two groups (A RFA with compression stocking for two weeks, B RFA alone). The primary outcome was ultrasound determined target vein obliteration at 12 weeks. Secondary outcome measures included a Quality of Life (QoL) score [Aberdeen Varicose Vein Severity Score (AVSS) and Revised Venous Clinical Severity Score (RVCSS)], patient satisfaction, pain score, and complications.

RESULTS:

In total, 100 consecutive patients were recruited (A 51; B 49) classified as clinical class C2-C6 of the Clinical-Etiological-Anatomical-Pathophysiological (CEAP) classification. At 12 weeks the occlusion rate of the target vein was similar in both groups at 98% (n = 47) and 98% (n = 45), respectively (p = 1.0). There was no statistically significant difference in mean AVSS 6 vs. 5.0 (mean difference -1, 95% CI -2 - 3, p = .57) and mean RVCSS 3 vs. 4 (mean difference 1, 95% CI -1 - 2, p = .46) scores at 12 weeks. Comparable patient satisfaction scores were observed (p = .72) and pain score 2.0 vs. 2.0 (p = .92) were achieved in both groups. Two patients in each group developed deep vein thrombosis at two weeks follow up (p = 1.0 for above the knee and p = 1.0 for below the knee).

CONCLUSION:

The clinical and patient reported outcomes following RFA without compression are no worse than with compression. This trial supports the conclusion that the widely practised use of compression after RFA adds no clinical benefit for the patients. However, a much larger study, preferably a multicentre trial, may be required to confirm this conclusion.
Subject(s)
Keywords

Full text: Available Collection: International databases Database: MEDLINE Document Type: Article Main subject: Varicose Veins / Compression Bandages / Radiofrequency Ablation Subject: Varicose Veins / Compression Bandages / Radiofrequency Ablation Type of study: Controlled clinical trial / Patient-preference Language: English Journal: Eur J Vasc Endovasc Surg Clinical aspect: Prognosis / Therapy Year: 2020

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Full text: Available Collection: International databases Database: MEDLINE Document Type: Article Main subject: Varicose Veins / Compression Bandages / Radiofrequency Ablation Subject: Varicose Veins / Compression Bandages / Radiofrequency Ablation Type of study: Controlled clinical trial / Patient-preference Language: English Journal: Eur J Vasc Endovasc Surg Clinical aspect: Prognosis / Therapy Year: 2020
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