[Radiofrequency ablation in comprehensive surgical treatment of patients with varicose veins of lower limbs].

Analysed herein are the results of using radiofrequency ablation (RFA) in comprehensive surgical treatment of patients presenting with varicose veins of the lower extremities. The study included a series of ninety-eight 28-to-60-year-old patients (with a total of 105 operations performed) suffering from varicose veins of the lower limbs. Of these, there were 10 men (10.3%) and 88 women (89.7%). Venous disease of clinical class C2 according to the CEAP classification was diagnosed in 80 patients, that of class C3 in 17, and that of class C4a in 1 patient. The procedure of RFA was performed by means of the VNUS device model RF62. The impact was exerted in an automatic mode, maintaining the catheter's temperature at 120° C during a 20-second treatment cycle for each 7 cm of the vein's length. In all cases, each 7-cm-long venous segment to be treated was acted upon 4 times. Forty-five patients after RFA underwent ultrasonographic monitoring performed first on POD 7 and then at 3, 6, 12 and 24 months. Recanalization of the trunk of the great saphenous vein (GSV) was registered in 3 (2.8%) cases at terms up to 3 months after the operation. In 2 cases recanalization turned out to be provoked by an incompetent perforant vein in the lower third of the femur. Seven (6.6%) patients with a large diameter of the great saphenous vein were found to develop post-closure hyperpigmentation which resolved spontaneously 8 months later. The remaining patients, with strict adherence to the indications for RFA, demonstrated complete obliteration of the vessel treated, with no recanalization observed ultrasonographically 10-12 months after the procedure. An additional experimental study with a morphological analysis confirmed appropriateness of carrying out four 20-second treatment cycles of RFA in each segment of the vein. A conclusion was made that RFA used in comprehensive surgical treatment for varicose veins of the lower limbs makes it possible to attain good therapeutic and cosmetic results that persist over time, if conducted in compliance with the mentioned fundamentally essential peculiarities of performing the procedure.