Background: The high ligation and stripping (HLS) of great saphenous vein (GSV) is the traditional method for surgical treatment of varicose vein (VVs) with high postoperative recurrence rate up to 60%, slow recovery, and obvious scar. Endovenous microwave ablation (MA) with high tie is considered a new technique of thermal ablation. We aimed to compare between (MA) with high tie versus traditional surgery for lower limb VVs regarding return to activity, complications, recurrence rate, and affection the Quality of Life (QoL).
Methods: This prospective comparative study was conducted on 50 cases, presented with symptomatic VVs, classified into two equal groups, MA with high tie group and traditional surgery group. The complications and possibility of recurrence were evaluated during 3, 6, and 12 m post intervention. The effect on QoL was assessed by the Aberdeen Varicose Vein Questionnaire.
Results: Operative incision was significantly fewer in MA with high tie group (P value <0.001). Return to activity was significantly faster in microwave ablation group (P value <0.001). Incidence of Ecchymosis and sensory impairment were significantly lower in MA with high tie group. EMA is more Recurrence at 12 m was significantly lower in MA with high tie group compared to traditional surgery group with hazard ratio (95% confidence interval) 0.2836 (0.08855 to 0.9085) (P =0.033). AVVQ was insignificant between both groups during assessment.
Conclusions: MA with high tie is an effective ablation method for VVs patients, that provides shorter time with less incisions, faster recovery with lower thermal-related complications, and recurrence rate.