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

Abdullah Güner , Volkan Burak Taban , SERKAN YILDIRIM, Yalçın Günerhan , Yüksel DERELİ

  • Abdullah Güner: KONYA ŞEHİR HASTANESİ
  • Volkan Burak Taban: Şırnak Devlet Hastanesi
  • SERKAN YILDIRIM: NECMETTİN ERBAKAN ÜNİVERSİTESİ
  • Yalçın Günerhan: Necmettin Erbakan Üniversitesi Tıp Fakültesi
  • Yüksel DERELİ: NECMETTİN ERBAKAN ÜNİVERSİTESİ Meram Tıp Fakültesi
  • Year : 2025
  • Vol : 41
  • Issue : 4
  •  Page : 189-193
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.
Cite this Article As : Guner A, Taban VB, Yildirim S, Gunerhan Y, Dereli Y. Comparison of Patients Undergoing Stripping, Endovenous Laser Ablation and Radiofrequency Ablation for Chronic Venous Insufficiency. Selcuk Med J 2025;41(4): 189-193

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Conflict of interest : The authors declare that they have no conflict of interest.
This article is published under the CC BY-NC 4.0 license.
Selcuk Medical Journal
2025, Vol. 41 (4)
ISSN: 1017-6616
E-ISSN: 2149-8059
Received : , Accepted : , Published Online :

References

  1. 1. Baliyan V, Tajmir S, Hedgire SS, et al. Lower extremity venous reflux. Cardiovascular diagnosis and therapy. 2016;6(6):533. doi:10.21037/cdt.2016.11.14
  2. 2. Ruckley CV, Evans CJ, Allan PL, et al. Chronic venous insufficiency: clinical and duplex correlations. The Edinburgh Vein Study of venous disorders in the general population. Journal of Vascular Surgery. 2002;36(3):520-5. doi:10.1067/mva.2002.126547
  3. 3. Labropoulos N, Leon M, Nicolaides AN, et al. Superficial venous insufficiency: correlation of anatomic extent of reflux with clinical symptoms and signs. Journal of vascular surgery. 1994;20(6):953-8. doi:10.1016/0741-5214(94)90233-x
  4. 4. Lo Y-F, Yang C-H, editors. Stripping and ligation of the saphenous vein. Seminars in cutaneous medicine and surgery; 2005. doi:10.1016/j.sder.2005.10.004
  5. 5. Eberhardt RT, Raffetto JD. Chronic venous insufficiency. Circulation. 2014;130(4):333-46. doi:10.1161/CIRCULATIONAHA.113.006898
  6. 6. Fowkes F, Lee AJ, Evans C, et al. Lifestyle risk factors for lower limb venous reflux in the general population: Edinburgh Vein Study. International journal of epidemiology. 2001;30(4):846-52. doi:10.1093/ije/30.4.846
  7. 7. Park TY, Jung J-W, Choi JC, et al. Epidemiological trend of pulmonary thromboembolism at a tertiary hospital in Korea. The Korean Journal of Internal Medicine. 2017;32(6):1037. doi:10.3904/kjim.2016.248
  8. 8. Lurie F, Passman M, Meisner M, et al. CEAP classification system and reporting standard, revision 2020. J Vasc Surg Venous Lymphat Disord. 2020;8(3):342-52. doi:10.1016/j.jvsv.2019.12.075
  9. 9. Işık M. Removal of the splitt guidewire forgotten during the treatment of varicose veins via radiofrequency ablation. Turkish Journal of Vascular Surgery. 2020;29(1). doi:10.9739/tjvs.2020.281
  10. 10. Dermody M, O'Donnell TF, Balk EM. Complications of endovenous ablation in randomized controlled trials. Journal of Vascular Surgery: Venous and Lymphatic Disorders. 2013;1(4):427-36. e1. doi:10.1016/j.jvsv.2013.04.007
  11. 11. Rajendran S, Nair HR, Thaikattil NJ. Ultrasound-assisted varicose vein surgery and endovenous laser ablation using 1470-nm laser for treatment of great saphenous vein incompetence has similar outcomes at 1 year in a single-center prospective randomized study. Journal of Vascular Surgery: Venous and Lymphatic Disorders. 2022;10(2):370-5. doi:10.1016/j.jvsv.2021.08.013
  12. 12. Helmy ElKaffas K, ElKashef O, ElBaz W. Great saphenous vein radiofrequency ablation versus standard stripping in the management of primary varicose veins-a randomized clinical trial. Angiology. 2011;62(1):49-54. doi:10.1177/0003319710380680
  13. 13. Rashid H, Ajeel A, Tyrrell MR. Persistent popliteal fossa reflux following saphenopopliteal disconnection. Journal of British Surgery. 2002;89(6):748-51. doi:10.1046/j.1365-2168.2002.02125.x
  14. 14. Hong KP. Midterm clinical outcomes after modified high ligation and segmental stripping of incompetent small saphenous veins. The Korean Journal of Thoracic and Cardiovascular Surgery. 2015;48(6):398. doi:10.5090/kjtcs.2015.48.6.398
  15. 15. Biemans AA, Kockaert M, Akkersdijk GP, et al. Comparing endovenous laser ablation, foam sclerotherapy, and conventional surgery for great saphenous varicose veins. Journal of vascular surgery. 2013;58(3):727-34. e1. doi:10.1016/j.jvs.2012.12.074
  16. 16. Jun J, Yoon M, Jung H, et al. Feasibility and Safety of Flush Endovenous Thermal Ablation of the Great Saphenous Vein with Consecutive Foam Sclerotherapy of Saphenofemoral Junction Tributaries: A Single-Center Experience. J Clin Med. 2024;13(23). doi:10.3390/jcm13237148
  17. 17. Miranda M, Sousa J, Mansilha A. PREVAIT after modern open surgery and endothermal ablation: a systematic review. Int Angiol. 2023;42(5):436-47. doi:10.23736/S0392-9590.23.05082-4
  18. 18. Eggen CA, Alozai T, Pronk P, et al. Ten-year follow-up of a randomized controlled trial comparing saphenofemoral ligation and stripping of the great saphenous vein with endovenous laser ablation (980 nm) using local tumescent anesthesia. Journal of Vascular Surgery: Venous and Lymphatic Disorders. 2022;10(3):646-53. e1. doi:10.1016/j.jvsv.2021.08.008
  19. 19. Rass K, Frings N, Glowacki P, et al. Same site recurrence is more frequent after endovenous laser ablation compared with high ligation and stripping of the great saphenous vein: 5 year results of a randomized clinical trial (RELACS Study). European Journal of Vascular and Endovascular Surgery. 2015;50(5):648-56. doi:10.1016/j.ejvs.2015.07.020
  20. 20. Dwerryhouse S, Davies B, Harradine K, et al. Stripping the long saphenous vein reduces the rate of reoperation for recurrent varicose veins: five-year results of a randomized trial. Journal of vascular surgery. 1999;29(4):589-92. doi:10.1016/s0741-5214(99)70302-2