Center for Interventional Medicine, The Fifth Affiliated Hospital, Sun Yat-sen University, Zhuhai, People's Republic of China.
Center for Interventional Medicine, The Fifth Affiliated Hospital, Sun Yat-sen University, Zhuhai, People's Republic of China; Guangdong Provincial Key Laboratory of Biomedical Imaging, The Fifth Affiliated Hospital, Sun Yat-sen University, Zhuhai, People's Republic of China; Guangdong Provincial Engineering Research Center of Molecular Imaging, The Fifth Affiliated Hospital, Sun Yat-sen University, Zhuhai, People's Republic of China.
J Vasc Surg Venous Lymphat Disord. 2024 Jan;12(1):101662. doi: 10.1016/j.jvsv.2023.03.022. Epub 2023 Aug 11.
Endovenous microwave ablation (EMA) is a recently developed thermal ablation technique used in the treatment of lower limb varicose veins. However, its efficacy and safety have been largely understudied. In the present study, we sought to explore the clinical results of EMA and radiofrequency ablation (RFA) in treating lower limb varicose veins.
Patients who underwent EMA (n = 65) or RFA (n = 46) at our institute from September 2018 to September 2020 were included in this retrospective investigation. The clinical results and complications were evaluated at 1, 3, 6, and 12 months after the procedure. The effects on disease severity and quality of life were evaluated using the venous clinical severity score and chronic venous insufficiency questionnaire (CIVIQ).
The technical success rate was 100% for both experimental groups. Although the operative time between the two groups was comparable, the EMA technique was associated with lower direct costs (P < .001), although also with prolonged hospitalization (P < .001). We found that the use of EMA correlated with more pain at 48 hours postoperatively. Except for the visual analog scale scores, no statistically significant variations were observed in the occurrence of postoperative complications within the first 48 hours postoperatively between the EMA and RFA groups, including paresthesia, ecchymosis, induration, and phlebitis (P > .05). At 4 weeks postoperatively, significantly less pigmentation was observed in the RFA group than in the EMA group (13.04% vs 32.31%; P = .020). However, the pigmentation had resolved in all patients by 12 months postoperatively. The two groups had a reduction in the venous clinical severity scores and an increase in the CIVIQ scores after the procedure. However, the CIVIQ scores within the RFA group had increased more than had those within the EMA group (P < .05). No significant differences were found in recurrence between the two groups (EMA group, 1.54%; RFA group, 2.17%; P = .804).
Both ablation techniques are safe and effective. RFA is associated with relatively higher treatment costs but shorter hospitalization and better quality of life improvement.
静脉内微波消融（EMA）是一种最近开发的用于治疗下肢静脉曲张的热消融技术。然而，其疗效和安全性在很大程度上仍未得到充分研究。在本研究中，我们旨在探讨 EMA 和射频消融（RFA）治疗下肢静脉曲张的临床结果。
本回顾性研究纳入了 2018 年 9 月至 2020 年 9 月期间在我院接受 EMA（n=65）或 RFA（n=46）治疗的患者。在术后 1、3、6 和 12 个月评估临床结果和并发症。使用静脉临床严重程度评分和慢性静脉功能不全问卷（CIVIQ）评估疾病严重程度和生活质量的影响。
两组的技术成功率均为 100%。虽然两组的手术时间相当，但 EMA 技术的直接成本较低（P<0.001），但住院时间较长（P<0.001）。我们发现 EMA 术后 48 小时疼痛更明显。除了视觉模拟量表评分外，两组术后 48 小时内并发症的发生率无统计学差异，包括感觉异常、瘀斑、硬结和静脉炎（P>0.05）。术后 4 周，RFA 组的色素沉着明显少于 EMA 组（13.04%比 32.31%；P=0.020）。然而，所有患者在术后 12 个月时色素沉着均已消退。两组术后静脉临床严重程度评分降低，CIVIQ 评分升高。然而，RFA 组的 CIVIQ 评分升高幅度大于 EMA 组（P<0.05）。两组之间复发率无显著差异（EMA 组 1.54%；RFA 组 2.17%；P=0.804）。
两种消融技术均安全有效。RFA 治疗费用相对较高，但住院时间短，生活质量改善更好。
