Work

Long-term outcomes of radiofrequency ablation versus cyanoacrylate closure for isolated small saphenous vein insufficiency: A comparative study

Year: 2025

Type: article

Abstract: BACKGROUND: Endovenous ablation is widely recommended for treating small saphenous vein (SSV) insufficiency, but isolated SSV (iSSV) reflux remains less frequently studied, especially in comparative settings. This study aimed to evaluate the clinical and anatomical outcomes of radiofrequency ablation (RFA) and cyanoacrylate closure (CAC) in patients with iSSV insufficiency. METHODS: A retrospective review was conducted using prospectively collected data from patients undergoing either modality for iSSV. Preoperative duplex ultrasound examination assessed anatomical patterns and reflux. Ablation strategies were tailored to anatomical variations. Follow-up duplex ultrasound examinations were performed at 6 months, 12 months, and up to 24 months in some patients (median follow-up, 12 months; range, 6-24 months). Outcomes included procedure time, vein occlusion rate, symptom improvement, complications, and changes in the Venous Clinical Severity Score and Aberdeen Varicose Vein Questionnaire. RESULTS: A total of 379 limbs in 306 patients were treated (85 with RFA and 294 with CAC). CAC had a longer procedure time than RFA (P < .001) and a higher occlusion rate at follow-up (99.3% vs 91.8%; P = .006). Both groups showed significant improvement in Venous Clinical Severity Score, Aberdeen Varicose Vein Questionnaire score, and pain scores (P < .001). Sural nerve injury occurred in two limbs treated with RFA and none with cyanoacrylate. Thrombus extension into the deep vein occurred in both groups, without a significant difference. CONCLUSIONS: Both RFA and CAC were effective and safe for treating iSSV insufficiency. Tailoring treatment to individual venous anatomy may improve outcomes and minimize complications such as sural nerve injury.

Source: Journal of Vascular Surgery Venous and Lymphatic Disorders

DOI: 10.1016/j.jvsv.2025.102317

Authors: Hyangkyoung Kim, Sungsin Cho, Se Jun Kim, Jin Hyun Joh

Institutions: Ewha Womans University, Ewha Womans University Mokdong Hospital, Kyung Hee University Hospital at Gangdong, Kyung Hee University

Language: English

Topic: Diagnosis and Treatment of Venous Diseases

Subfield: Surgery

Field: Medicine

Domain: Health Sciences

SDG: Good health and well-being

Open Access status: gold

Estimated APC paid: $2,400