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J Vasc Surg Venous Lymphat Disord 2022 May 10. Epub 2022 May 10.

Background: Bleeding is a rare but potentially life-threatening complication of varicose veins. There is paucity of literature about patients with varicose veins that present with bleeding and the effectiveness of vein ablation as therapy to prevent recurrent bleeding. This study compares patients treated with vein ablation for bleeding varicose veins to patients treated for venous symptoms other than bleeding. Read More

Ann Ital Chir 2022 ;93:235-240

Objective: The present study aims to investigate the therapeutic effect and safety of radiofrequency ablation (RFA) of the great saphenous vein in the treatment of varicose veins of the lower extremities.

Methods: Sixty-nine affected limbs of 45 patients were treated with RFA of the great saphenous vein. All patients underwent retrograde puncture of the distal great saphenous vein under the guidance of B-ultrasound. Read More

Phlebology 2022 May 1;37(4):303-311. Epub 2022 Mar 1.

Department of Vascular Surgery, 60664Oulu University Hospital, Oulu, Finland.

Background: The benefits of postoperative compression are not well established following radiofrequency ablation of the truncal vein and concomitant foam sclerotherapy.

Methods: A total of 104 patients were randomized: Postoperatively, 54 patients received no compression and 50 patients received class II thigh-high compression. The primary outcome for this study was the difference between means on postoperative pain scores over the first 10 days follow-up measured on a visual analog scale (VAS) from 0 to 100 mm (prespecified delta 10 mm). Read More

Phlebology 2022 Apr 4;37(3):223-225. Epub 2022 Jan 4.

Laboratory of Research in Vascular Surgery, 9354IRCCS Istituto Auxologico Italiano, Milan, Italy.

Quality of life (QoL) in patients with chronic venous disorders has a central role to decide the correct treatment approach. In particular, in case of mini-invasive therapy, such as endovenous radiofrequency ablation (RFA), the postoperative QoL improvement remains one of the most important outcome to be reached. Despite this, very few data are published on the long-term QoL modifications after RFA. Read More

Phlebology 2022 Apr 30;37(3):165-179. Epub 2021 Dec 30.

Department of Surgery, 1140Northwest Clinics, Alkmaar, The Netherlands.

Objective: To investigate and compare the outcomes of the available treatment modalities for anterior accessory saphenous vein (AASV) incompetence.

Methods: A systematic literature search was performed in MEDLINE, Embase, and the Cochrane Library. Studies reporting the outcomes of patients who were treated for primary AASV incompetence were included. Read More

Phlebology 2022 Mar 23;37(2):112-119. Epub 2021 Sep 23.

Department of Histopathology, University Hospital Galway and National University of Ireland, Galway, Ireland.

Objective: Current minimally invasive techniques for ablation in superficial venous reflux are limited to thermal based systems requiring tumescent anesthesia, non-thermal chemical sclerosants and permanent glue implantation. The aim of this feasibility study was to determine the safety and efficacy of a novel mechanical-only ablation (MOA) device called EnVena, in a recognised large animal model with chronic follow up.

Methods: Venous ablation of six lateral saphenous veins in three sheep was performed using the EnVena device. Read More

Phlebology 2022 Feb 10;37(1):48-54. Epub 2021 Sep 10.

Vascular Surgery Unit, IRCCS San Raffaele Scientific Institute, Milan, Italy.

Objective: to compare the outcomes of mechanochemical ablation (MOCA) versus saphenopopliteal junction ligation and stripping (OS) for symptomatic small saphenous vein (SSV) insufficiency.

Methods: This is a retrospective study including symptomatic SSV patients treated with MOCA using the ClariVein catheter (Merit Medical, South Jordan, Utah, USA) or OS from 2015 to 2019.

Results: A total of 60 limbs (73. Read More

Vasc Health Risk Manag 2021 2;17:379-387. Epub 2021 Jul 2.

Teaching and Health Care Unit of Vascular and Endovascular Surgery's Medical Staff, Pedro Ernesto University Hospital (HUPE), Rio de Janeiro State University (UERJ), Rio De Janeiro, Brazil.

Objective: This study assessed the outcomes and impact on the quality of life following one-step outpatient radiofrequency ablation (RFA) and ultrasound guided foam sclerotherapy (USGFS) for large reflux with varicosities in the great saphenous vein (GSV).

Design: Prospective, single-centre, analytical cohort.

Materials And Methods: Thirty symptomatic patients having reflux in the GSV and varicosities (CEAP C3 to C6) were treated with RFA and USGFS simultaneously, in a single-step procedure, from March 2016 to December 2016. Read More

Surg Innov 2022 Apr 27;29(2):234-240. Epub 2021 May 27.

Department of Cardiovascular Surgery, Medical Faculty, 162307Istanbul Medipol University, Istanbul, Turkey.

: In the current study, we present single surgeon experience of a new radiofrequency ablation system, the catheter, and the device. : The new system, which comprises a generator and an intervally illuminated radiofrequency ablation catheter, was used for the treatment of 272 consecutive patients with chronic venous insufficiency of the great saphenous vein between November 2017 and October 2018. Mean age of the patients was 53. Read More

Vascular 2022 Apr 24;30(2):375-383. Epub 2021 Apr 24.

Department of Cardiovascular Surgery, Bakirkoy Dr Sadi Konuk Training and Research Hospital, Istanbul, Turkey.

Objective: To compare the use of high saphenous ligation and stripping, radiofrequency ablation, and subfascial endoscopic perforator surgery for the treatment of active venous ulcers.

Methods: One hundred ninety-five ( = 195) subjects who were treated for venous leg ulcers were enrolled between 2009 and 2014. Three groups were formed (Group A: high saphenous ligation and total stripping, Group B: radiofrequency ablation of the great saphenous vein + perforators, and Group C: radiofrequency ablation of the great saphenous vein + subfascial endoscopic perforator surgery) ( = 65 for each group). Read More

Beijing Da Xue Xue Bao Yi Xue Ban 2021 Mar;53(2):332-336

Department of Interventional Radiology and Vascular Surgery, Peking University Third Hospital, Beijing 100191, China.

Objective: To explore the technical details and short-term effects of radiofrequency obliteration of varicose veins of lower extremities guided by combined venography and ultrasound.

Methods: Thirty-seven patients with varicose veins of lower extremities were treated with radiofrequency obliteration using Olympus Celon RFiTT under combined guidance of venography and ultrasound. The indications included varicose veins of lower extremities and reflux of the great saphenous vein confirmed by ultrasound. Read More

J Vasc Surg Venous Lymphat Disord 2021 11 9;9(6):1443-1450. Epub 2021 Mar 9.

Divisions of Cardiovascular Medicine, Vascular Surgery and Endovascular Therapy, Yale School of Medicine, New Haven, Conn.

Objective: The aim of the present study was to examine the relationship between the great saphenous vein (GSV) length of segment ablated and diameter with symptom improvement.

Methods: Data from a multicenter, randomized, controlled prospective study of 242 patients undergoing radiofrequency ablation (RFA) or cyanoacrylate closure (CAC) of the GSV were analyzed. The venous clinical severity score (VCSS) was measured at baseline and at 1, 3, 6, 12, 24, and 36 months after ablation. Read More

J Vasc Surg Venous Lymphat Disord 2021 07 26;9(4):1071-1076.e1. Epub 2021 Feb 26.

Promedica, Jobst Vascular Institute, Toledo, Ohio. Electronic address:

Objective: Nonhealing leg ulcers are frequently associated with the saphenous vein reflux. Despite the success of endovascular ablations, there are patients who either fail to heal or develop recurrent ulcers. This systematic review aims to summarize the available evidence on how to treat these patients after successful elimination of superficial reflux. Read More

J Vasc Surg Venous Lymphat Disord 2021 09 13;9(5):1215-1221. Epub 2021 Jan 13.

Department of Vascular Surgery, MedStar Washington Hospital Center, Washington, D.C.

Objective: Venous leg ulcers (CEAP [clinical, etiologic, anatomic, pathophysiologic] class 6) represent the most severe form of chronic venous insufficiency. As closure techniques for superficial venous reflux evolve, direct outcome comparisons of treatments are integral, because many studies have already demonstrated that early endovenous intervention improves wound healing. The present study compared the rates of venous wound healing between two techniques of superficial vein closure: ClosureFast radiofrequency ablation (RFA) and adhesive closure (VenaSeal; both Medtronic, Inc, Minneapolis, Minn). Read More

J Vasc Surg Venous Lymphat Disord 2021 07 27;9(4):932-937. Epub 2020 Nov 27.

Division of Vascular Surgery, Department of Surgery, Yale University School of Medicine, New Haven, Conn. Electronic address:

Background: Varicose veins are commonly caused by valvular reflux in the saphenous vein. Most insurance companies will approve venous ablation (VA) for the treatment of junctional reflux only and will deny coverage for symptomatic patients with significant nonjunctional reflux of the saphenous vein at the deep system. The present study compared the outcomes of VA for patients with junctional reflux and patients with nonjunctional reflux. Read More

J Vasc Surg Venous Lymphat Disord 2021 07 25;9(4):954-960. Epub 2020 Nov 25.

Department of Vascular Surgery, Oulu University Hospital, Oulu, Finland.

Objective: We evaluated the effect of first-visit foam sclerotherapy compared with scheduled treatment for patients with venous ulceration.

Methods: The study design was a retrospective comparative study. From December 2009 to October 2019, a total of 245 venous ulcers in 214 patients (including recurrent ulcers) were treated at Oulu University Hospital. Read More

J Vasc Surg Venous Lymphat Disord 2021 07 26;9(4):904-909. Epub 2020 Nov 26.

Gonda (Goldschmied) Vascular Center, Division of Vascular Surgery, David Geffen School of Medicine at UCLA, Los Angeles, Calif.

Objective: Thrombus extension into the deep venous system following superficial vein chemical ablation with Varithena polidocanol microfoam has been reported. The objective of this study was to assess the effect of intraoperative improved techniques during treatment for patients with symptomatic varicose veins and their impact on extension of thrombus into deep veins.

Methods: A retrospective review of a prospectively maintained database was performed. Read More

J Vasc Surg Venous Lymphat Disord 2021 07 10;9(4):925-931. Epub 2020 Nov 10.

Department of Thoracic and Cardiovascular Surgery, Konkuk University Medical Center, Konkuk University School of Medicine, Seoul, Republic of Korea.

Objective: The aim of the present study was to investigate the occurrence of skin complications after mechanochemical ablation with the ClariVein device (Merit Medical, South Jordan, Utah) for incompetent great saphenous veins (GSVs) and compare the results in terms of the target vein characteristics, especially in the presence of an epifascial GSV tributary.

Methods: A single-center, retrospective study was performed. We reviewed 33 limbs of 32 patients with GSV insufficiency who had undergone mechanochemical ablation with the ClariVein device from December 2017 to February 2020. Read More

Phlebology 2021 May 11;36(4):283-289. Epub 2020 Nov 11.

Division of Vascular and Endovascular Surgery, Mayo Clinic, Jacksonville, FL, USA.

Background: To review long-term outcomes and saphenous vein (SV) occlusion rate after endovenous ablation (EVA) for symptomatic varicose veins.

Methods: A review of our EVA database (1998-2018) with at least 3-years of clinical and sonographic follow-up. The primary end point was SV closure rate. Read More

Int J Hyperthermia 2020 ;37(1):1238-1247

Physics for Medicine Paris, Inserm, ESPCI Paris, CNRS, PSL Research University, Paris, France.

Background: Varicose veins are a common disease that may significantly affect quality of life. Different approaches are currently used in clinical practice to treat this pathology.

Materials And Methods: In thermal therapy (radiofrequency or laser therapy), the vein is directly heated to a high temperature to induce vein wall coagulation, and the heat induces denaturation of the intramural collagen, which results macroscopically in vein shrinkage. Read More

JAMA Surg 2020 12;155(12):1113-1121

Department of Surgery and Cancer, Imperial College London, London, United Kingdom.

Importance: One-year outcomes from the Early Venous Reflux Ablation (EVRA) randomized trial showed accelerated venous leg ulcer healing and greater ulcer-free time for participants who are treated with early endovenous ablation of lower extremity superficial reflux.

Objective: To evaluate the clinical and cost-effectiveness of early endovenous ablation of superficial venous reflux in patients with venous leg ulceration.

Design, Setting, And Participants: Between October 24, 2013, and September 27, 2016, the EVRA randomized clinical trial enrolled 450 participants (450 legs) with venous leg ulceration of less than 6 months' duration and superficial venous reflux. Read More

Ann Vasc Surg 2021 Feb 18;71:1-8. Epub 2020 Sep 18.

Minneapolis Heart Institute®, at Abbott Northwestern Hospital - Part of Allina Health, Minneapolis, MN.

Background: The objective of this study was to evaluate risk factors, incidence, management, and outcome of endovenous heat-induced thrombosis (EHIT) related to radiofrequency ablation (RFA).

Methods: This was a single-center retrospective analysis of patients over the age of 18 who underwent RFA between 2016 and 2019. Demographics, comorbidities, medications, severity scores, vascular anatomy, procedural details, and outcome data were collected. Read More

Phlebology 2021 Mar 9;36(2):127-134. Epub 2020 Sep 9.

Cornwall Vein Clinic, Ramsay Duchy Hospital, Truro, UK.

Background: To review the clinical experience and early outcomes of endothermal perforator ablation.

Method: Retrospective review of an endovenous practice from 2007-2019. Clinically significant incompetent perforators were treated by Endovenous Laser Ablation (EVLA), or segmental radiofrequency ablation (RFA). Read More

Laryngoscope 2021 03 10;131(3):566-570. Epub 2020 Aug 10.

Department of Otolaryngology, Head and Neck Surgery, Peking University First Hospital, Beijing, People's Republic of China.

Objective: To explore the feasibility and efficacy of transoral radiofrequency coblation surgery (TRS) in the treatment of adult laryngopharyngeal vascular lesion (LVL).

Methods: A total of 15 patients with LVL were retrospectively studied, including 11 capillary lesions and five cavernous lesions (there was one case with two separate lesions). All of the lesions were treated with TRS alone (capillary lesion) or with a combination of TRS and sclerotherapy (cavernous lesion). Read More

Ann Vasc Surg 2021 Jan 27;70:109-115. Epub 2020 Jun 27.

Division of Vascular Surgery, University of Pittsburgh, Pittsburgh, PA.

Background: Venous leg ulceration (VLU) represents the most advanced form of chronic venous insufficiency (CVI). Persistent VLU that fails to respond to noninvasive treatment requires a minimally invasive endovascular treatment, which may include chemical (ultrasound-guided foam sclerotherapy [UGFS]) and thermal ablation (endovenous laser therapy [EVLT] or radiofrequency ablation [RFA]) targeting incompetent veins. Current guidelines suggest ablation of incompetent perforating veins (IPVs) juxtaposed to active or healed VLU; however, the ideal treatment modality is unknown. Read More

Med Arch 2020 Apr;74(2):100-104

Department of Radiology, Bach Mai Hospital, Hanoi, Vietnam.

Introduction: Chronic venous insufficiency (CVI) is a chronic condition, triggered by reflux through the saphenous vein network.

Aim: To determine the efficacy of endovenous laser ablation (LA) and radiofrequency ablation (RFA) for CVI treatment in the lower extremities, at the Bach Mai Radiology Center.

Methods: This retrospective study was approved by the institutional review board of Bach Mai Hospital. Read More

J Vasc Surg Venous Lymphat Disord 2021 01 1;9(1):137-145. Epub 2020 May 1.

Department for Dermatology, Ruhr-University Bochum, Bochum, Germany.

Objective: Although many studies have demonstrated that endovenous therapies have comparable efficacy to crossectomy and stripping, few studies have been published regarding the classification and recurrence patterns of varicose veins after endovenous therapy. This study attempted to provide an objective scheme for the definition and classification of recurrence. Moreover, it describes the types and rates of recurrence after endovenous thermal ablation, as well as factors associated with recurrence. Read More

Ann Vasc Surg 2020 Oct 25;68:172-178. Epub 2020 Apr 25.

Phlebolymphology Unit, General Surgery Department, Hospital Italiano de Buenos Aires, Argentina.

Background: To describe the occlusion rate and clinical response of a redo ablative procedure in symptomatic patients with recanalization of saphenous vein after endovascular thermal ablation.

Methods: A retrospective cohort study was performed in a prospectively collected data of symptomatic patients with recanalization of the great saphenous vein (GSV) or small saphenous vein (SSV) after endovascular thermal ablation who underwent a secondary ablation (SA) from June 2015 to May 2018.

Results: Ten patients (15 limbs) with recanalization of the GSV or SSV were treated with SA. Read More

J Vasc Surg Venous Lymphat Disord 2020 11 19;8(6):1021-1024. Epub 2020 Apr 19.

Vascular Institute of New York, Brooklyn, NY.

Objective: Lower extremity endovenous ablation has become the primary treatment modality for symptomatic venous reflux disease. Endovenous heat-induced thrombosis (EHIT) has been reported as one of the primary complications of these venous ablative procedures. Our aim was to determine how long EHITs take to resolve and the factors affecting this length of time. Read More

Phlebology 2020 Sep 19;35(8):561-565. Epub 2020 Mar 19.

Department of Cardiovascular Surgery, Şişli Hamidiye Etfal Research and Training Hospital, Istanbul, Turkey.

Objectives: F-care (endovenous radiofrequency, F Care Systems, Antwerp, Belgium) is a relatively new radiofrequency ablation technique for the treatment of venous insufficiency. There is a lack of published data about F-care in literature. This study aimed to prospectively compare the F-care method with conventional endovenous radiofrequency ablation Closurefast method for the management of incompetent great saphenous veins. Read More