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Radiofrequency Ablation Increases the Incidence of Endothermal Heat-Induced Thrombosis.

Abstract：

BACKGROUND:Endovenous thermal ablation has become the procedure of choice in the treatment of superficial venous reflux disease. The current armamentarium of devices and techniques aimed at the elimination of saphenous reflux offers surgeons and interventionalists a variety of treatment options; however, there is a lack of data comparing the safety of these products. The most concerning complication after endovenous thermal ablation is endothermal heat-induced thrombosis (EHIT) due to the risk of progression to deep venous thrombosis. This study aimed to compare the incidence rate of EHIT between radiofrequency ablation (RFA) and endovenous laser therapy (EVLT). METHODS:This was a single-center, office-based, retrospective study over the course of 5 years, in which 3,218 consecutive patients underwent 10,029 endovenous saphenous ablations. The patient cohort was 66.2% female, with an average age of 61.9 years. At the time of each individual intervention, 24, 212, 3,620, 4,806, 200, and 1,167 patients had Clinical-Etiology-Anatomy-Pathophysiology disease 1, 2, 3, 4, 5, and 6, respectively. RESULTS:There was a total of 3,983 EVLT and 6,091 RFA procedures. The most common vessel treated was the great saphenous vein, 63.6% of the time, followed by the small saphenous vein (25.6%), accessory saphenous vein (6.1%), and perforator vein (4.6%). There were 186 cases of EHIT, with 137 (73.6%) identified as type 1 as per the Kabnick classification. Endovenous ablation performed via RFA resulted in significantly more cases of EHIT than of EVLT (109 vs. 77; P = 0.034; odds ratio = 1.52), which was confirmed by a multivariate analysis. CONCLUSIONS:In the largest single-center study of endovenous saphenous ablations to date, RFA was shown to pose a significantly higher risk of EHIT than of EVLT.

journal_name

Ann Vasc Surg

journal_title

Annals of vascular surgery

authors

Chait J,Kibrik P,Alsheekh A,Ostrozhynskyy Y,Marks N,Rajaee S,Hingorani A,Ascher E

doi

10.1016/j.avsg.2019.05.059

subject

Has Abstract

pub_date

2020-01-01 00:00:00

pages

263-267

eissn

0890-5096

issn

1615-5947

pii

S0890-5096(19)30555-2

journal_volume

pub_type

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Radiofrequency Ablation Increases the Incidence of Endothermal Heat-Induced Thrombosis.