Great saphenous vein radiofrequency ablation versus standard stripping in the management of primary varicose veins-a randomized clinical trial.

INTRODUCTION: Chronic venous insufficiency is the most common vascular disease in the adult population. However, randomized clinical trials (RCTs) comparing therapeutic options are limited.

PATIENTS AND METHODS: A total of 180 patients with saphenofemoral junction and great saphenous reflux detected on duplex were randomized to either ultrasound-guided radiofrequency ablation (RFA) or standard surgical treatment. The study participants blindly chose an assignment card that placed them in either group A (ultrasound-guided RFA of the great saphenous vein [GSV]; n = 90); or group B (surgical management n = 90). Patients were followed up for 24 months.

RESULTS: The primary occlusion rate in group A was 94.5% versus 100% in group B. Radiofrequency ablation had a lower overall complication rate (P = .02) and shorter post-intervention hospital stay (P = .001). Kaplan-Meier analysis showed no significant differences in recurrence rates at 24 months follow-up (P = .45). Radiofrequency ablation was significantly more expensive (P = .003).

CONCLUSION: Great saphenous vein occlusion was achieved efficiently in 94% of our group using RFA with minimal complications and obvious advantages as compared to standard surgery.