A PROSPECTIVE COMPARATIVE STUDY OF RADIOFREQUENCY ABLATION VERSUS SUBFASCIAL ENDOSCOPIC PERFORATOR SURGERY FOR THE TREATMENT OF VARICOSITIES IN VARICOSE VEINS PATIENTS.

Abstract

Introduction: Dilated & tortuous subcutaneous veins 3mm or more in diameter are known as varicose veins. When perforating veins become incompetent, it causes chronic venous insufficiency. Majority cases are managed conservatively. Cases with significant skin changes and ulcers, requires surgical procedures.

Methods: A prospective comparative study of 30 patients of varicosities, divided into two groups, A and B according to CEAP classification were assessed for VCSS preoperatively. They underwent radiofrequency ablation (RFA) and subfascial endoscopic perforator surgery (SEPS) respectively and postoperative VCSS was calculated at follow up at 4 weeks. Collected data was assessed for the change in clinical severity of the disease and compared for the complications of both surgical methods.

Results: The mean difference of pre op and post op VCSS in patient treated by RFA is 6.0 and the mean difference of pre op and post op VCSS in patient treated by SEPS is 5.4. Post RFA complications include pain (20%) and ecchymosis (13.3%). Paraesthesia and DVT was not noted. Post SEPS complications include pain (40%), ecchymosis (40%) and paresthesia (13.33%). DVT was not noted post SEPS. Only 1 case (6.66%) treated by SEPS developed recurrence post operatively. Conclusion: RFA and SEPS are two different approaches for varicosities, RFA being truncal therapy and SEPS for perforators, both are almost equally effective in context of postoperative hospital stay and improvement of VCSS; safe in terms of post op complications.

Keywords: Radiofrequency ablation (RFA), Subfascial endoscopic perforator surgery (SEPS), venous clinical severity score (VCSS), varicose veins