Comparison of Patients Undergoing Stripping, Endovenous Laser Ablation and Radiofrequency Ablation for Chronic Venous Insufficiency

Objective: There are several treatment modalities for chronic venous insufficiency(CVI) of the lower extremities. The aim of this study was to compare stripping, radiofrequency ablation(RFA) and endovenous laser ablation(EVLA) for the treatment of CVI in terms of recurrence, deep vein thrombosis(DVT) and phlebitis complications in the first postoperative year.
Materials and Methods: Total of 442 patients with vena saphena magna(VSM) diameter over 5.5 mm and reflux duration over 0.5 s who were admitted to our clinic between 2018 and 2023 and underwent stripping, RFA or EVLA were retrospectively included in the study. Results of colour doppler ultrasound(CDUSG) were analysed in the first postoperative year. Patients under 18 years of age, pregnant and/or lactating patients, patients with a history of DVT, and patients with symptoms of peripheral vascular disease were excluded from the study.
Results: The mean age of the patients included in the study was 46±12.3 years, 266 (60.2%) were female and 176 (39.8%) were male. Stripping procedure was performed in 143, RFA in 179 and EVLA in 120 patients. Although the incidence of phlebitis and DVT was higher in patients who underwent EVLA, this difference was not statistically significant (p=0.166, 0.252 respectively). When the recurrence rate detected on CDUSG was analysed according to the type of procedure at 1 year post-operatively, no statistically significant difference was found between RFA and EVLA, while a statistically lower recurrence rate was observed in the stripping procedure compared to RFA and EVLA (p=0.035, 0.002, respectively). Conclusion: This study did not find significant differences in DVT rates among the procedures, but the results reveal that stripping had lower phlebitis rates and significantly fewer recurrences compared to RFA and EVLA after one year.