Clinical efficacy and safety analysis of ultrasound-guided radiofrequency ablation for varicose veins of lower extremities.

OBJECTIVE

To compare the efficacy of ultrasound-guided radiofrequency ablation (RFA) and high ligation and stripping (HL/S) for lower extremity varicose veins (VV).

METHODS

Clinical data from 160 VV patients treated at Hangzhou Fuyang Hospital of Traditional Chinese Medicine between January 2023 and December 2024 were retrospectively analyzed. Patients were assigned to either the RFA group (n = 82, ultrasound-guided RFA) or the HL/S group (n = 78, HL/S) based on the treatment modality. Operative time, intraoperative blood loss, length of stay (LOS), Visual Analogue Scale (VAS) scores, levels of bradykinin (BK), substance P (SP), plasminogen activator inhibitor-1 (PAI-1), fibrinogen (Fib), dorsal foot vein pressure, complication rates, and 1-month follow-up outcomes including 36-Item Short Form Survey (SF-36) scores and venous clinical severity scores (VCSS) were compared between the two groups.

RESULTS

The RFA group demonstrated shorter operative time, less blood loss, and shorter LOS compared to the HL/S group ( < 0.05). On postoperative days 1, 3, and 7, VAS scores were significantly lower in the RFA group compared to the HL/S group ( < 0.05). On postoperative day 7, levels of BK, SP, PAI-1, Fib, and dorsal foot vein pressure were significantly lower in the RFA group ( < 0.05). At 1-month follow-up, the RFA group showed a lower complication rate, higher SF-36 scores, and lower VCSS compared to the HL/S group ( < 0.05).

CONCLUSION

Ultrasound-guided RFA outperformed HL/S in reducing perioperative trauma, pain, dorsal foot vein pressure, and coagulation and inflammatory markers, while offering higher safety and improved short-term quality of life for VV patients.