About some tactical aspects of the use of radiofrequency ablation in The treatment of varicose disease of the lower extremities in outpatient care
DOI:
https://doi.org/10.11603/2414-4533.2020.4.11785Keywords:
mini-phlebectomy, echo-sclerotherapyAbstract
The aim of the work: to give clinical evaluation of the results of using radio frequency ablation in treating varicose veins in order to increase the indications for its implementation in the outpatient setting.
Materials and Methods. During 2016–2019, 928 patients with varicose veins C2-C4 were monitored for classification of CEAP. There were 538 (58 %) women, and 390 (42 %) men, aged from 18 to 72 years. To eliminate the vertical reset RFA was used according to the method of VNUS – Closure FAST, using the device COVIDIEN, Medtronics manufacturer.
Results and Discussion. The ultrasound examination of the stem of saphenous veins demonstrated that following RFA, out of 928 patients, 46 (5 %) had the recanalization of GSV after a year, and 84 (9 %) patients – after three years. No reliable difference in the clinical effect was observed in patients with SGV diameters, exceeding 16 mm, in both groups after one and three years. We would like to highlight that after three months of observation, the involution of collaterals was achieved in 58 % of patients who had undergone monoablation. In 78 (8.4 %) patients were simultaneously performed radiofrequency ablation with sclerotherapy perforant veins on the shin 3 % solution of polydocanol. In 312 patients, after obliterating the trunk of a large subcutaneous vein performed delayed (after 3 months) minimally invasive operations (mini-phlebectomy, foam ECHO obliteration of perforate veins or their radiofrequency ablation stiletto electrode). Radiofrequency monoablation with delayed ultrasound-guided sclerotherapy is a considerably less traumatic and short-term method compared to simultaneous surgical treatment, which provides for its wide application for elderly patients and people with multimorbid concurrent pathology in the outpatient setting.
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