Background
Minimally invasive endovenous thermal ablation therapy has revolutionized the treatment of varicose veins. Comparison of radiofrequency ablation (RFA) versus Endovenous Laser Ablation (EVLA) needs to be more elaborated in the context of better management of patients.
Patients and methods
A total of 50 young patients (10 patient bilateral and 40 patients unilateral) were enrolled in a prospective interventional study over a period of 2 years starting from June 2014. All patients were blinded to the chosen method to achieve a single-blinded study, with two groups. Exclusion criteria included deep vein thrombosis, peripheral arterial disease, severe tortuosity of Great saphenous Vein (GSV), and refusal of consent. All patients were assessed for deep system patency and flow in ablated segment by duplex immediately after procedure and 1 month later.
Results
Overall, 60 limbs were equally allocated to two groups. There was no significant difference between both groups concerning the demography and clinical, etiologic, anatomic, and pathophysiologic classification. All patients were blinded to the method of venous ablation. Postoperative duplex shows no failed recanalization or deep vein thrombosis. Pain, ecchymosis, and superficial thrombophlebitis were significantly higher in EVLA group versus RFA group (<0.05). Surprisingly, first-degree burn occurred in two (6.6%) cases in EVLA group.
Conclusion
Both thermal ablative techniques performed well concerning high occlusion rates for incompetent GSV. Less postoperative complications were observed with RFA as compared with EVLA, namely, postoperative pain, ecchymosis, superficial thrombophlebitis, and first-degree burn. However, such complications were deemed to be benign and managed conservatively.