Secondary Ablation of Recanalized Saphenous Vein after Endovenous Thermal Ablation

Ann Vasc Surg. 2020 Oct:68:172-178. doi: 10.1016/j.avsg.2020.04.017. Epub 2020 Apr 25.

Abstract

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. The median age was 67 years and 60% were men. The median time from the first ablation was 7.3 years (interquartile range [IQR] 6.5-9.6). For SA, radiofrequency ablation was performed in 12 limbs (80%) and ultrasound-guided foam sclerotherapy in 3 cases (20%). The GSV was the treated vessel in 14 cases (93.3%). No complications were reported. Median follow-up was 13 months. Preoperative and 1-year follow-up Venous Clinical Severity Score was 9 (IQR 5-10) and 4 (IQR 2-8), respectively. Duplex ultrasound evaluation after 1 year showed an occlusion rate of 93.3% evidencing a partially recanalized vein in 1 treated limb.

Conclusions: In this study, the occlusion rate was 93.3% at 1 year after SA; clinical improvement and no complications were reported. SA appears to be a valid option for the treatment of symptomatic patients with recanalized GSV or SSV.

MeSH terms

  • Ablation Techniques* / adverse effects
  • Adult
  • Aged
  • Chronic Disease
  • Databases, Factual
  • Endovascular Procedures* / adverse effects
  • Female
  • Humans
  • Male
  • Middle Aged
  • Reoperation
  • Retrospective Studies
  • Saphenous Vein / diagnostic imaging
  • Saphenous Vein / surgery*
  • Time Factors
  • Treatment Outcome
  • Ultrasonography, Doppler, Duplex
  • Varicose Veins / diagnostic imaging
  • Varicose Veins / surgery*
  • Venous Insufficiency / diagnostic imaging
  • Venous Insufficiency / surgery*