To compare the efficacy of compression stockings worn for 7 days or overnight after EVRFA.
Methods
A single-centre, prospective, non-inferiority randomised controlled trial. The study included patients with clinical class C2–C4 chronic venous disease who underwent endovenous radiofrequency ablation (EVRFA) at Chulabhorn Hospital between October 2021 and October 2023. Sixty patients were assigned to wear the overnight compression group (n = 30) or for the 7-day compression group (n = 30). The primary outcome was targeted vein obliteration at 12 weeks. The secondary outcome measures were the revised Venous Clinical Severity Score (r-VCSS), Aberdeen Varicose Veins Severity Score (AVSS), pain score, complications and patient satisfaction.
Results
At 12 weeks, both groups had a 100% target vein occlusion rate. There was no statistically significant difference in the r-VCSS, AVSS, patient satisfaction score, complications or pain score at day 1, day 14 and 12–16 weeks after the procedure. Overnight compression improved r-VCSS significantly.
Conclusion
Overnight compression was non-inferior to compression for 7 days after EVRFA.
VuylstekeMEThomisSGuillaumeG, et al.Epidemiological study on chronic venous disease in Belgium and Luxembourg: prevalence, risk factors, and symptomatology. Eur J Vasc Endovasc Surg2015; 49: 432–439.
2.
National Institute for Health and Care Excellence. Varicose veins in the legs: the diagnosis and management of varicose veins. London, UK: National Institute for Health and Care Excellence, 2013. Available from: https://www.nice.org.uk/guidance/cg168/chapter/1-recommendationsAccessed January 15, 2024.
3.
LurieFLalBKAntignaniPL, et al.Compression therapy after invasive treatment of superficial veins of the lower extremities: clinical practice guidelines of the American venous Forum, society for vascular surgery, American College of phlebology, society for vascular medicine, and international union of phlebology. J Vasc Surg Venous Lymphat Disord2019; 7: 17–28.
4.
De MaeseneerMGKakkosSKAherneT, et al.Editor’s choice – European society for vascular surgery (ESVS) 2022 clinical practice guidelines on the management of chronic venous disease of the lower limbs. Eur J Vasc Endovasc Surg2022; 63: 184–267.
5.
TrevorJRhodesJHardyJ, et al.Postoperative limb compression in reduction of haemorrhage after varicose vein surgery. Ann R Coll Surg Engl1993; 75: 119–122.
6.
RasmussenLBjoernLLawaetzM, et al.Randomized trial comparing endovenous laser ablation of the great saphenous vein with high ligation and stripping in patients with varicose veins: short-term results. J Vasc Surg2007; 46: 308–315.
7.
ShoulerPRunchmanP. Varicose veins: optimum compression after surgery and sclerotherapy. Ann R Coll Surg Engl1989; 71: 402–404.
8.
RabeEPartschHMorrisonN, et al.Risks and contraindications of medical compression treatment – a critical reappraisal. An international consensus statement. Phlebology2020; 35: 447–460.
9.
RasmussenLHLawaetzMBjoernL, et al.Randomized clinical trial comparing endovenous laser ablation, radiofrequency ablation, foam sclerotherapy and surgical stripping for great saphenous varicose veins. Br J Surg2011; 98: 1079–1087.
10.
RautioTOhinmaaAPeräläJ, et al.Endovenous obliteration versus conventional stripping operation in the treatment of primary varicose veins: a randomized controlled trial with comparison of the costs. J Vasc Surg2002; 35: 958–965.
11.
PassarielloFGoldmanMMordonS, et al.The mechanism of action of LASER and radiofrequency in great saphenous vein thermal ablation. Acta Phlebol2010; 11: 35–39.
12.
HuHWangJWuZ, et al.No benefit of wearing compression stockings after endovenous thermal ablation of varicose veins: a systematic review and meta-analysis. Eur J Vasc Endovasc Surg2022; 63: 103–111.
13.
OnwudikeMAbbasKThompsonP, et al.Role of compression after radiofrequency ablation of varicose veins: a randomised controlled trial. Eur J Vasc Endovasc Surg2020; 72: 751.
14.
PihlajaTRomsiPOhtonenP, et al.Post-procedural compression vs. no compression after radiofrequency ablation and concomitant foam sclerotherapy of varicose veins: a randomised controlled non-inferiority trial. Eur J Vasc Endovasc Surg2020; 59: 73–80.
15.
AyoDBlumbergSNRockmanCR, et al.Compression versus no compression after endovenous ablation of the great saphenous vein: a randomized controlled trial. Ann Vasc Surg2017; 38: 72–77.
16.
Houtermans-AuckelJPvan RossumETeijinkJA, et al.To wear or not to wear compression stockings after varicose vein stripping: a randomised controlled trial. Eur J Vasc Endovasc Surg2009; 38: 387–391.
17.
ChouJHChenSYChenYT, et al.Optimal duration of compression stocking therapy following endovenous thermal ablation for great saphenous vein insufficiency: a meta-analysis. Int J Surg2019; 65: 113–119.
18.
HuangTWChenSLBaiCH, et al.The optimal duration of compression therapy following varicose vein surgery: a meta-analysis of randomized controlled trials. Eur J Vasc Endovasc Surg2013; 45: 397–402.
19.
MohamedAHThadaniSMohamedSH, et al.Compression following treatment of superficial venous incompetence: systematic review. Br J Surg2022; 109: 679–685.
20.
BootunRBelrammanABolton-SaghdaouiL, et al.Randomized controlled trial of compression after endovenous thermal ablation of varicose veins (COMETA trial). Ann Surg2021; 273: 232–239.
21.
MiiSGuntaniAYoshigaR, et al.Optimal duration of compression stocking therapy after endovenous laser ablation using a 1470-nm diode dual-ring radial laser fiber for great saphenous vein insufficiency. Ann Vasc Dis2021; 14: 122–131.
22.
KrasznaiAGSigtermanTATroquayS, et al.A randomised controlled trial comparing compression therapy after radiofrequency ablation for primary great saphenous vein incompetence. Phlebology2016; 31: 118–124.
23.
CoelhoFAraújoWJBBelczakS, et al.Influence of compression therapy following varicose vein surgery: a prospective randomized study. J Vasc Bras2023; 22: e20220052.
