Endovenous radiofrequency ablation and varicose veins of the lower limbs with active venous ulcer

Abstract

Purpose: To investigate the effectiveness of outpatient minimally invasive procedure application in patients with the varicose disease of the lower limbs with active venous ulcer. Can endovenous radiofrequency ablation (RFA) become the main method of treatment of superficial and perforating vein incompetence in patients with associated venous ulcers? Materials and methods. RFA saphenous vein of the lower limbs was performed in 17 patients with varicose vein disease with clinical disease class of C6 according to the CEAP classification. “Medtronic” apparatus with “VNUS Closure Fast” technology was used for the RFA.

Results: Venous ulcers localized on the right limbs in 10 and on the left limbs in 7 patients. The number of trophic ulcers was within the range from 1 to 12, nine out of which were solitary ulcers. 8 patients showed 2 and more ulcers. The sizes of ulcers were from 5 mm along the minimal longitudinal axis and up to 90 mm along its maximal one, making up an average of 20,06±1,78 mm and 52,74±25,47 mm accordingly, and reaching the maximum size of 90 mm by 55 mm. The duration of ulcers existence was from 6 to 72 months, which average constituted 33,76±6,47 months. The mean diameter of a great saphenous vein (GSV) was 12,82±1,03 mm. The mean diameter of a small saphenous vein (SSV) was 3,94±0,57 mm. RFA of solely GSV was performed in 12 patients, of both vein (GSV and SSV) was performed in 4 patients and of solely SSV was performed in 1 patient. The duration of RFA was 33,82±2,07 minutes on average. The number of cycles of RFA was from 10 to 22, with its average of 17,47±0,80 for one patient. Trophic ulcers cured in all patients within the timeframe from 14 to 60 days.

Conclusions: 1. Endovenous Radiofrequency Ablation is a highly effective means of treatment of superficial and perforating vein incompetence in patients with associated active venous ulcers. 2. Endovenous Radiofrequency Ablation can be used in an outpatient situation as a monosurgical method of active venous ulcers treatment.