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VSI Vascular Specialist International

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pISSN 2288-7970
eISSN 2288-7989
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Original Article

하지정맥류 고주파치료술의 임상결과

The Clinical Outcomes of Endovenous Radiofrequency Ablation of Varicose Veins: Results from the Korean Radiofrequency Ablation Registry

조진현1ㆍ박호철1ㆍ김우식2ㆍ정인목3ㆍ박기혁4ㆍ윤우성4ㆍ이태승5
Jin Hyun Joh, M.D.1, Ho-Chul Park, M.D.1, Woo-Shik Kim, M.D.2, In Mok Jung, M.D.3,Ki Hyuk Park, M.D.4, Woo-Sung Yun, M.D.4 and Taeseung Lee, M.D.5
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Department of Surgery, Kyung Hee University Hospital at Gangdong1;Department of Cardiothoracic Surgery, National Medical Center2;Department of Surgery, Seoul Metropolitan Government-Seoul National University Boramae Medical Center3, Seoul;Department of Surgery, Daegu Catholic University Hospital4, Daegu;Department of Surgery, Seoul National University Bundang Hospital5, Seongnam, Korea

Department of Surgery, Kyung Hee University Hospital at Gangdong1;Department of Cardiothoracic Surgery, National Medical Center2;Department of Surgery, Seoul Metropolitan Government-Seoul National University Boramae Medical Center3, Seoul;Department of Surgery, Daegu Catholic University Hospital4, Daegu;Department of Surgery, Seoul National University Bundang Hospital5, Seongnam, Korea

Korean J Vasc Endovasc Surg 2013; 29(3): 91-97

Published August 28, 2013 https://doi.org/10.5758/kjves.2013.29.3.91

Copyright © The Korean Society for Vascular Surgery.

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Abstract

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Purpose: Radiofrequency ablation (RFA) has been used as an alternative to conventional high ligation and stripping surgery for the treatment of saphenous vein insufficiency. A Korean clinical registry was established in 2012. The purpose of our study is to report the clinical outcomes of RFA from the Korean RFA Registry. Methods: Data were collected in a multicenter, retrospective registry. All patients were treated before March 31, 2013. The indication for RFA was clinical, etiology, anatomy, and pathophysiology (CEAP) clinical class C2?C6 and patients with disease-associated symptoms, complications, or cosmetic concerns. We retrospectively reviewed the clinical outcomes, such as CEAP score, venous clinical severity score (VCSS), and quality of life (QoL) score after RFA using ClosureFAST (Covidien) catheter. The paired and independent t-test using IBM SPSS ver. 19.0 (IBM Co.) was used for the statistical analysis to evaluate the clinical improvement after treatment. Results: There were 698 patients (890 limbs) treated with RFA at 5 centers in Korea. The average age was 53.7±12.0 years (range, 19 to 89 years) with a body mass index of 23.1±2.8 kg/m2, 58.2% of the patients were female. All saphenous veins with reflux ≥0.5 seconds were ablated simultaneously. The most common complication was ecchymosis, which occurred in 41 patients (5.9%). All clinical parameters were significantly improved. At the mean follow-up of 13.9 months, the occlusion rate was 94.6% in great saphenous vein and 94.5% in small saphenous vein. Conclusion: RFA is an effective modality in the treatment of saphenous vein insufficiency. The clinical parameters including CEAP class, VCSS and QoL score showed significant improvement after RFA.

Keywords

Varicose veins, Catheter ablation, Radiofrequency, Ultrasonography

References

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  1. Perrin MR, Guex JJ, Ruckley CV, dePalma RG, Royle JP, Eklof B, et al. Recurrent varices after surgery (REVAS), a consensus document. REVAS group. Cardiovasc Surg 2000;8:233-245.
    Pubmed
  2. Carradice D, Mekako AI, Mazari FA, Samuel N, Hatfield J, Chetter IC. Randomized clinical trial of endovenous laser ablation compared with conventional surgery for great saphenous varicose veins. Br J Surg 2011;98:501-510.
    CrossRef
  3. Siribumrungwong B, Noorit P, Wilasrusmee C, Attia J, Thakkinstian A. A systematic review and meta-analysis of randomised controlled trials comparing endovenous ablation and surgical intervention in patients with varicose vein. Eur J Vasc Endovasc Surg 2012;44:214-223.
    Pubmed CrossRef
  4. Almeida JI, Kaufman J, Gockeritz O, Chopra P, Evans MT, Hoheim DF, et al. Radiofrequency endovenous ClosureFAST versus laser ablation for the treatment of great saphenous reflux: a multicenter, single-blinded, randomized study (RECOVERY study). J Vasc Interv Radiol 2009;20:752-759.
    Pubmed CrossRef
  5. Shepherd AC, Gohel MS, Brown LC, Metcalfe MJ, Hamish M, Davies AH. Randomized clinical trial of VNUS ClosureFAST radiofrequency ablation versus laser for varicose veins. Br J Surg 2010;97:810-818.
    Pubmed CrossRef
  6. Gale SS, Lee JN, Walsh ME, Wojnarowski DL, Comerota AJ. A randomized, controlled trial of endovenous thermal ablation using the 810-nm wavelength laser and the ClosurePLUS radiofrequency ablation methods for superficial venous insufficiency of the great saphenous vein. J Vasc Surg 2010;52:645-650.
    Pubmed CrossRef
  7. Nordon IM, Hinchliffe RJ, Brar R, Moxey P, Black SA, Thompson MM, et al. A prospective double-blind randomized controlled trial of radiofrequency versus laser treatment of the great saphenous vein in patients with varicose veins. Ann Surg 2011;254:876-881.
    Pubmed CrossRef
  8. Merchant RF, Pichot O; Closure Study Group. Long-term outcomes of endovenous radiofrequency obliteration of saphenous reflux as a treatment for superficial venous insufficiency. J Vasc Surg 2005;42:502-509.
    Pubmed CrossRef
  9. Garratt AM, Macdonald LM, Ruta DA, Russell IT, Buckingham JK, Krukowski ZH. Towards measurement of outcome for patients with varicose veins. Qual Health Care 1993;2:5-10.
    Pubmed PMC CrossRef
  10. Vasquez MA, Rabe E, McLafferty RB, Shortell CK, Marston WA, Gillespie D, et al. Revision of the venous clinical severity score: venous outcomes consensus statement: special communication of the American Venous Forum Ad Hoc Outcomes Working Group. J Vasc Surg 2010;52:1387-1396.
    Pubmed CrossRef
  11. Dwerryhouse S, Davies B, Harradine K, Earnshaw JJ. Stripping the long saphenous vein reduces the rate of reoperation for recurrent varicose veins: five-year results of a randomized trial. J Vasc Surg 1999;29:589-592.
    CrossRef
  12. Fischer R, Linde N, Duff C, Jeanneret C, Chandler JG, Seeber P. Late recurrent saphenofemoral junction reflux after ligation and stripping of the greater saphenous vein. J Vasc Surg 2001;34:236-240.
    Pubmed CrossRef
  13. van Rij AM, Jones GT, Hill GB, Jiang P. Neovascularization and recurrent varicose veins: more histologic and ultrasound evidence. J Vasc Surg 2004;40:296-302.
    Pubmed CrossRef
  14. Stucker M, Netz K, Breuckmann F, Altmeyer P, Mumme A. Histomorphologic classification of recurrent saphenofemoral reflux. J Vasc Surg 2004;39:816-821.
    Pubmed CrossRef
  15. Theivacumar NS, Darwood R, Gough MJ. Neovascularisation and recurrence 2 years after varicose vein treatment for sapheno-femoral and great saphenous vein reflux: a comparison of surgery and endovenous laser ablation. Eur J Vasc Endovasc Surg 2009;38:203-207.
    Pubmed CrossRef
  16. Puggioni A, Kalra M, Carmo M, Mozes G, Gloviczki P. Endovenous laser therapy and radiofrequency ablation of the great saphenous vein: analysis of early efficacy and complications. J Vasc Surg 2005;42:488-493.
    Pubmed CrossRef
  17. Goode SD, Chowdhury A, Crockett M, Beech A, Simpson R, Richards T, et al. Laser and radiofrequency ablation study (LARA study): a randomised study comparing radiofrequency ablation and endovenous laser ablation (810 nm). Eur J Vasc Endovasc Surg 2010;40:246-253.
    Pubmed CrossRef
  18. Smith SR, Goldman MP. Tumescent anesthesia in ambulatory phlebectomy. Dermatol Surg 1998;24:453-456.
    CrossRef
  19. Lohr J, Kulwicki A. Radiofrequency ablation: evolution of a treatment. Semin Vasc Surg 2010;23:90-100.
    Pubmed CrossRef
  20. Zikorus AW, Mirizzi MS. Evaluation of setpoint temperature and pullback speed on vein adventitial temperature during endovenous radiofrequency energy delivery in an in-vitro model. Vasc Endovascular Surg 2004;38:167-174.
    CrossRef
  21. Altin FH, Kutas B, Gunes T, Aydin S, Eygi B. A comparison of three tumescent delivery systems in endovenous laser ablation of the great saphenous vein. Vascular 2013 Mar 19 [Epub].
    Pubmed CrossRef
  22. Marsh P, Price BA, Holdstock J, Harrison C, Whiteley MS. Deep vein thrombosis (DVT) after venous thermoablation techniques: rates of endovenous heat-induced thrombosis (EHIT) and classical DVT after radiofrequency and endovenous laser ablation in a single centre. Eur J Vasc Endovasc Surg 2010;40:521-527.
    Pubmed CrossRef
  23. Mozes G, Kalra M, Carmo M, Swenson L, Gloviczki P. Extension of saphenous thrombus into the femoral vein: a potential complication of new endovenous ablation techniques. J Vasc Surg 2005;41:130-135.
    Pubmed CrossRef
  24. Lawrence PF, Chandra A, Wu M, Rigberg D, DeRubertis B, Gelabert H, et al. Classification of proximal endovenous closure levels and treatment algorithm. J Vasc Surg 2010;52:388-393.
    Pubmed CrossRef

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