Home Current issue Ahead of print Search About us Editorial board Archives Submit article Instructions Subscribe Contacts Login 
ORIGINAL ARTICLE
Year : 2014  |  Volume : 33  |  Issue : 2  |  Page : 110-116

Healing and recurrence rates following radiofrequency ablation of the saphenous vein and ultrasound-guided foam sclerotherapy of perforator reflux in patients with venous ulceration


Vascular and Endovascular Surgery Unit, Faculty of Medicine, Zagazig University, Zagazig, Egypt

Correspondence Address:
Wael Elshimy
Vascular and Endovascular Surgery Unit, Faculty of Medicine, Zagazig University, 44523 Zagazig
Egypt
Login to access the Email id

Source of Support: None, Conflict of Interest: None


DOI: 10.4103/1110-1121.131671

Rights and Permissions

Background Chronic venous ulcer (CVU) is responsible for significant healthcare expenditure worldwide. Compression therapy is the mainstay of treatment, but long-term compliance with this therapy is difficult. Surgery for axial and perforator reflux has been used as an adjuvant to compression to fasten healing and reduce recurrence rates. The treatment of varicose veins has also undergone dramatic changes with the introduction of percutaneous endovenous ablation techniques, including radiofrequency ablation (RFA) and ultrasound-guided foam sclerotherapy (UGFS). The role of these techniques in the treatment of CVU is just beginning to be defined. Patients and methods Sixty-six patients with CVU with 71 active leg ulcers who presented at our vascular clinic were included in this study. All patients underwent duplex scanning for venous insufficiency. Ulcer dimensions at each visit were recorded and used to calculate healing rates. The presence or absence of ulcer recurrence at 1-year follow-up was recorded. Ulcers treated with compression alone (the 'compression group') were compared with those treated with compression and minimally invasive interventions, such as RFA of superficial axial reflux and UGFS of incompetent perforating veins and varicosities (the 'intervention group'). Results The average age in the intervention and compression groups was 36.7 and 41 years, respectively (P = NS). Ulcers were recurrent in 41.7% of the patients in the intervention group and in 25.5% of patients in the compression group (P = NS). In the intervention group 14.7% underwent RFA of the axial reflux, 38.2% underwent UGFS of perforators, and 41.1% underwent both treatments. The only complication of intervention was a single case of cellulitis requiring hospitalization. No significant difference (P = 0.73) was seen in the proportion of ulcers that did not heal within 24 weeks (24.3% compression vs. 17.5% intervention). Within 1 year a significantly higher rate of recurrence was seen in the compression group compared with the intervention group (46 vs. 20.5%; P = 0.004). Conclusion Minimally invasive ablation of superficial axial and perforator vein reflux in patients with active CVU is safe and leads to faster healing and decreased ulcer recurrence when combined with compression alone in the treatment of CVU.


[FULL TEXT] [PDF]*
Print this article     Email this article
 Next article
 Previous article
 Table of Contents

 Similar in PUBMED
   Search Pubmed for
   Search in Google Scholar for
 Related articles
 Citation Manager
 Access Statistics
 Reader Comments
 Email Alert *
 Add to My List *
 * Requires registration (Free)
 

 Article Access Statistics
    Viewed1366    
    Printed18    
    Emailed0    
    PDF Downloaded94    
    Comments [Add]    

Recommend this journal