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Abstract

Background

The objective of this study was to compare the efficacy and safety of endovenous microwave ablation (EMA) and high ligation and stripping (HLS) for the treatment of small saphenous vein insufficiency..

Methods

This single-center retrospective study consecutively enrolled patients with small saphenous vein insufficiency who underwent either endovenous microwave ablation (EMA) or high ligation and stripping (HLS). Clinical severity was assessed using the Clinical-Etiology-Anatomy-Pathophysiology (CEAP) classification and the Venous Clinical Severity Score (VCSS). Quality of life was evaluated using the Aberdeen Varicose Vein Questionnaire (AVVQ) and the Chronic Venous Insufficiency Questionnaire-14 (CIVIQ-14). Perioperative complications and vein closure rates were recorded. The primary outcome was technical and anatomical vein closure at 6 and 12 months postoperatively. Secondary outcomes included operative time, postoperative complications, symptom improvement, and quality-of-life changes. Propensity score matching was performed to minimize baseline confounding between groups.The objective of this study was to compare the efficacy and safety of endovenous microwave ablation (EMA) and high ligation and stripping (HLS) for the treatment of small saphenous vein insufficiency.

Results

Following propensity score matching (PSM), the baseline characteristics between the two groups were comparable. EMA demonstrated a significantly shorter operative time compared to HLS (p < 0.001). Improvements in both symptoms and clinical severity scores were significantly greater and occurred more rapidly in the EMA group (p < 0.01). Regarding postoperative complications, the incidence rates of paresthesia and numbness were significantly lower in the EMA group compared to the HLS group (p < 0.05). However, improvements in health-related quality of life and 12-months safety indicators showed no significant differences between the two groups (p > 0.05).

Conclusion

The study findings confirm that endovenous microwave ablation (EMA) significantly improves quality of life in patients with small saphenous vein (SSV) insufficiency. Compared to high ligation and stripping (HLS), EMA demonstrates superior minimally invasive characteristics, facilitates faster recovery, and provides better symptom relief within the first year post-procedure. Furthermore, its long-term safety profile is non-inferior to HLS, collectively resulting in higher patient satisfaction.

Keywords

small saphenous vein varicosities high ligation and stripping (HLS)endovenous microwave ablation (EMA)propensity score matching controlled clinical study

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Endovenous microwave ablation versus high ligation and stripping for the treatment of small saphenous vein incompetence. A single center retrospective study