Long-term results of minimally invasive treatment of varicose veins of the lower extremities: the experience of the Almazov Centre

Abstract

Objective. The purpose of our retrospective single-center study was assessing the long-term results of radiofrequency obliteration (RFO) in patients with varicose veins of the lower extremities and causes of disease recurrence. Design and methods. We included 406 patients with reflux in the great saphenous vein (GSV), who underwent RFO either alone (n = 81; 19.9 %) or in combination with miniphlebectomy (n = 284; 70 %) or sclerotherapy (n = 41; 10.1 %) during the period from 2013 to 2022. Results. Primary occlusion of the target vein was achieved in 406 (100 %) patients. 26 (6.4 %) patients had recurrent varicose veins (RVV). In 18 (4.4 %) patients with “early” relapses in a period of 3 to 6 months, we diagnosed the incompetence of the anterior accessory vein — 6 (1.5 %) or tributaries 12 (3 %). Among 8 patients (2 %) with “late” relapse in the period from 24 to 36 months, 6 (1.5 %) had recanalization of tributaries and 2 (0.5 %) had neovasculogenesis. In all cases of RVV patients underwent additional interventions with 100% technical success. Conclusion. The most important factors of RVV are tactical and technical errors associated with the primary underestimation of venous system anatomy; absence or insufficiently long postoperative observation; relapse associated with neovasculogenesis. Considering the main role of the first two reasons, their minimization can significantly reduce the risk of RVV.