Comparative analysis of early outcomes of radiofrequency ablation and 1470-nm endovenous laser ablation in the treatment of great saphenous vein insufficiency

Abstract

Background: Minimally invasive Endovenous Thermal Ablation Therapy has revolutionized the treatment of varicose veins. Comparison of radiofrequency ablation (RFA) and Endovenous Laser Ablation (EVLA) needs to be more elaborated in the context of better management of patients. The objective of this study is to compare 1470-nm endovenous laser Ablation (EVLA) and radiofrequency ablation (RFA) in the treatment of patients with great saphenous vein Insufficiency. Methods: There were 100 consecutive patients presenting to our department with a great saphenous vein insufficiency treated between June 2018 and June 2019 who were included in the study. The first randomly selected 50 patients (group 1) received 1470-nm EVLA and the other 50 patients (group 2) received RFA. Patients were assessed on the second day, the first week, and the first month in terms of post-operative complications, return to routine activity and work, and postoperative pain. Results: 50 patients were allocated to each group. There was no statistically significant difference between two groups in terms of postoperative pain. Time to return to daily activity was 5.1 ± 1.12 hours in the EVLA group and 6.9 ± 0.93 hours in the RFA group (P = 0.001), whereas time to return to work was 6.7 ± 1.03 days in the EVLA group and 7.4 ± 1.07 days in the RFA group (P = 0.003). Minor complications in EVLA and RFA group were ecchymosis 26% and 32% (P = 0.509) edema 24% and 34% (P = 0.271), and induration 14% and 22% (P = 0.298), respectively. No major complication were observed in any group. Conclusion: EVLA using a 1470-nm radial fiber is an acceptable and efficacious treatment option over RFA in management of symptomatic varicose veins patients in terms of early outcome. However, long term follow up and more studies on larger populations are required to establish the superiority of either method.