A comparison of four different endovenous ablation techniques

Background: This study aims to investigate the efficacy of radiofrequency ablation and endovenous laser ablation techniques and the impact on the quality of life of patients. Methods: Between October 2011 and October 2012, 472 extremities of a total of 368 patients (258 females, 110 males; mean age 41.2 years; range 24 to 62 years) who were admitted to our Cardiovascular clinic and underwent endovenous ablation for symptomatic varicose veins were included in the study. Of the patients, 1470 nm wavelength diode laser in 34.1% (n=161), 980 nm wavelength diode laser in 20.1% (n=95), radiofrequency ablation in 26.3% (n=124), and 1470 nm wavelength radial fiber laser in 26.3% (n=124) was applied. These techniques were compared in terms of the postoperative complications, complete occlusion, recanalization rates, and patient comfort. Results: Any major complication such as deep venous thrombosis, pulmonary embolism, and skin burn was observed in none of the patients. Postoperative pain and paresthesias were similar in the endovenous laser ablation groups. Radiofrequency ablation group had lesser postoperative pain and ecchymosis (n=9; n=2; p<0.05). Ecchymosis were mostly seen in 1470 nm wavelength radial diode laser group (n=12; p<0.05) and 980 nm wavelength diode laser group (n=15; p<0.05). At six months, recanalization was observed in the 1470 nm wavelength diode laser group (n=2) and in the 980 nm wavelength diode laser group (n=2). At one year, we observed recanalization in four patients in the radiofrequency ablation group, which did not statistical significance. Conclusion: Considering the same recanalization rates with endovenous laser ablation, lower need for tumescent anesthesia, effective use of thermal energy, and low complication rates, we recommend radiofrequency ablation technique in the treatment of superficial venous insufficiency.