One-year clinical and anatomical outcomes of endovenous radiofrequency ablation for saphenous vein insufficiency: A real-world cohort study

Abstract

Objectives

Endovenous radiofrequency ablation (RFA) is an established minimally invasive treatment for saphenous vein insufficiency. This study evaluated 1-year clinical and anatomical outcomes of RFA in a real-world cohort, including staged adjunctive interventions when indicated.

Methods

This retrospective study initially evaluated 99 patients with symptomatic saphenous vein insufficiency. Of these, 84 patients, corresponding to 90 treated limbs, completed follow-up and were included in the final analysis. Among these, 74 patients underwent great saphenous vein (GSV) ablation (including 6 bilateral procedures, totaling 80 limbs), and 10 patients underwent small saphenous vein (SSV) ablation. Clinical outcomes were assessed using the Venous Clinical Severity Score (VCSS), while Clinical-Etiology-Anatomy-Pathophysiology (CEAP) classification was used to describe baseline disease severity.

Results

The overall occlusion rate across all treated limbs was 88/90 (97.7%). In the GSV subgroup, mean VCSS decreased significantly from 6.0 ± 1.5 at baseline to 2.2 ± 1.2 at 12 months (p < .001). In the SSV subgroup, mean VCSS decreased from 5.5 ± 0.5 to 2.0 ± 1.0, demonstrating comparable clinical improvement. Ten limbs (12.5% of the GSV limbs) required adjunctive sclerotherapy for symptomatic residual tributaries. Minor complications included transient paresthesia in 7 limbs (7.7%), all of which resolved during follow-up. One patient (1.2%) developed Ablation-Related Thrombus Extension (ARTE), which was managed conservatively without sequelae.

Conclusion

Endovenous RFA provided high occlusion rates, significant clinical improvement, and a favorable safety profile at 1 year. These findings support RFA as an effective treatment option for both GSV and SSV insufficiency in routine clinical practice.

Keywords

endovenous radiofrequency ablation saphenous vein insufficiency chronic venous disease venous clinical severity score duplex ultrasound varicose veins

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