Medium And Long-term Efficacy Of Radiofrequency Ablation Compared To Conventional High Ligation And Stripping For The Treatment Of Great Saphenous Varicose Veins

Objective: To compare and evaluate the short-term med-and long-term clinical benifits and safety of radiofrequency ablation(RFA)and conventional high ligation stripping(HLS)in the treatment of great saphenous varicose veins,and to analyze the risk factors of recurrence.Methods: Clinical data were retrospectively collected from 875 patients(1,156 limbs)with varicose veins in the lower limbs visited in The University of Hong Kong Shenzhen hospital between January 2016 and December 2018.670 of patients(including 881 limbs)were treated with HLS and 205(including 275 limbs)with RFA.To evaluate the severity of the clinical manifestations of venous diseases with the Venous Clinical Severity Score(VCSS),quality of life with the Venous Disease Quality of Life Score(AVVQ),and saphenous vein closure and its recurrence with Doppler ultrasound at 1,3,6 months,3,4 and 5 years after surgery.Results: 875 patients were included in this study;670 were in the HLS group and 205 were in the RFA group.Both RFA and HLS can effectively occlude the main saphenous vein at the early stage(P>0.05).VCSS scores and AVVQ scores were significantly decreased in RFA and HLS groups at 1,3 and 6 months,suggesting that both of the two surgical methods could improve patients’ quality of life,but the RFA group had fewer complications.The subgroup analysis further suggested that RFA had a better clinical prognosis for CEAP class C2-C3(P < 0.05).Logistic regression analysis showed that paraplegia,deep venous regurgitation and perforator were risk factors for recurrence.Conclusion:Both the RFA and the HLS had good short-term med-and long-term clinical benifits.The paraplegic vein,deep venous regurgitation and perforating branches are risk factors for postoperative recurrence.