Phlebologie 2017; 46(05): 278-280
DOI: 10.12687/phleb2394-5-2017
Review
Schattauer GmbH

Avoiding aesthetic complications after endovenous radiofrequency ablation

Vermeidung von ästhetischen Komplikationen nach endovenöser Radiofrequenzablation
D. Bissacco
1   ASST Fatebenefratelli-Sacco, Vascular Surgery Unit, Milan, Italy
,
S. Stegher
1   ASST Fatebenefratelli-Sacco, Vascular Surgery Unit, Milan, Italy
,
F. M. Calliari
1   ASST Fatebenefratelli-Sacco, Vascular Surgery Unit, Milan, Italy
,
M. P. Viani
1   ASST Fatebenefratelli-Sacco, Vascular Surgery Unit, Milan, Italy
› Author Affiliations
Further Information

Publication History

Received: 07 August 2017

Accepted: 08 August 2017

Publication Date:
04 January 2018 (online)

Summary

Radiofrequency endovenous ablation treatment is a safe, effective and durable technique for the treatment of great saphenous vein truncal incompetence. However, it is associated with relatively rare complications, such as ecchymosis, paresthesia, hyperpigmentation, phlebitis, haematoma, deep vein thrombosis and pulmonary embolism. Among these, aesthetic complications are the most frequent minor complications occurred after the procedure. This brief review defines and describes aesthetic complications after endovenous radiofrequency ablation of great saphenous vein and provides useful tips to minimize their incidence. Aesthetic complications can be avoided with a careful and accurate preoperative patient and vein evaluation, proper operative indication, adherence to procedure and device instruction for use and best postoperative management.

Zusammenfassung

Endovenöse Radiofrequenzablation ist ein sicheres, effektives und dauerhaftes Verfahren für die Behandlung von Vena Saphena Magna Stamminsuffizienz. Allerdings, seltene Komplikationen können auftreten, wie Ekchymose, Parästhesie, Hyperpigmentierung, Phlebitis, Hämatom, tiefe Beinvenenthrom-bose und Lungenembolie. Unter diesen sind ästhetische Komplikationen die häufigsten leichten Komplikationen nach diesem Eingriff. Dieser Artikel stellt eine kurze Review der ästhetischen Komplikationen nach Radio-frequenzablation von Vena saphena magna Stamminsuffizienz dar, und bietet nützliche Hinweise um ihre Inzidenz zu minimieren. Ästhetische Komplikationen können vermieden werden durch sorgfältige und akkurate prä-operative Patienten- und Venenevaluation, geeignete operative Indikation, Einhaltung der Bedienungsanleitungen des Gerätes, und beste postoperative Versorgung.

 
  • References

  • 1 Brar R. et al. Surgical management of varicose veins: meta-analysis. Vascular 2010; 18 (Suppl. 04) 205-220.
  • 2 Gloviczki P. et al. The care of patients with varicose veins and associated chronic venous diseases: clinical practice guidelines of the Society for Vascular Surgery and the American Venous Forum. J Vasc Surg 2011; 53 (Suppl. 05) 2S-48S.
  • 3 Wittens C. et al. Management of Chronic Venous Disease: Clinical Practice Guidelines of the European Society for Vascular Surgery (ESVS). Eur J Vasc Endovasc Surg 2015; 49 (Suppl. 06) 678-737.
  • 4 Nesbitt C. et al. Endovenous ablation (radiofrequency and laser) and foam sclerotherapy versus open surgery for great saphenous vein varices. Cochrane Database Syst Rev 2014; 7: CD005624.
  • 5 Dermody M. et al. Complications of endovenous ablation in randomized controlled trials. J Vasc Surg Venous Lymphat Disord 2013; 1 (Suppl. 04) 427-436.
  • 6 Health Quality Ontario.. Endovascular laser therapy for varicose veins: an evidence-based analysis. Ont Health Technol Assess Ser 2010; 10 (Suppl. 06) 1-92.
  • 7 Almeida JI. et al. Radiofrequency endovenous ClosureFAST versus laser ablation for the treatment of great saphenous reflux: a multicenter, single-blinded, randomized study (RECOVERY study). J Vasc Interv Radiol 2009; 20 (Suppl. 06) 752-759.
  • 8 Nordon IM. et al. A prospective double-blind randomized controlled trial of radiofrequency versus laser treatment of the great saphenous vein in patients with varicose veins. Ann Surg 2011; 254 (Suppl. 06) 876-881.
  • 9 Proebstle TM. et al. Treatment of the incompetent great saphenous vein by endovenous radiofrequency powered segmental thermal ablation. J Vasc Surg 2008; 47 (Suppl. 01) 151-156.
  • 10 Siribumrungwong B. et al. A systematic review and meta-analysis of randomised controlled trials comparing endovenous ablation and surgical intervention in patients with varicose vein. Eur J Vasc Endovasc Surg 2012; 44 (Suppl. 02) 214-223.
  • 11 Creton D, Pichot O, Sessa C. et al. Radiofrequency-powered segmental thermal obliteration carried out with the ClosureFast procedure: results at 1 year. Ann Vasc Surg 2010; 24 (Suppl. 03) 360-366.
  • 12 Murad MH. et al. A systematic review and meta-analysis of the treatments of varicose veins. J Vasc Surg 2011; 53 (Suppl. 05) 49S-65S.
  • 13 Merchant RF, Pichot O. Closure Study Group. Long-term outcomes of endovenous radiofrequency obliteration of saphenous reflux as a treatment for superficial venous insufficiency. J Vasc Surg 2005; 42 (Suppl. 03) 502-509.
  • 14 Kabnick LS. Complications of endovenous therapies: statistics and treatment. Vascular 2006; 14 (Suppl. 01) S31-32.
  • 15 Tesmann J. Radiofrequency ablation of varicose veins. Phlebologie 2017; 46: 137-142.
  • 16 Zikorus AW, Mirizzi MS. Evaluation of set point temperature and pullback speed on vein adventitial temperature during endovenous radiofrequency energy delivery in an in-vitro model. Vasc Endovascular Surg 2004; 38 (Suppl. 02) 167-174.
  • 17 Merchant RF. et al. Four-year follow-up on endovascular radiofrequency obliteration of great saphenous reflux. Dermatol Surg 2005; 31: 129-134.
  • 18 Covidien (UK) Commercial Ltd.. Instructions for use: ClosureFast catheter (package insert). Hampshire, UK: 2014
  • 19 Welch HJ. Endovenous ablation of the great saphenous vein may avert phlebectomy for branch varicose veins. J Vasc Surg 2006; 44 (Suppl. 03) 601-605.
  • 20 Darwood RJ, Gough MJ. Endovenous laser treatment for uncomplicated varicose veins. Phlebology 2009; 24 (Suppl. 01) 50-61.
  • 21 Bootun R. et al. To compress or not to compress the eternal question of the place of compression after endovenous procedures. Phlebology 2016; Sep 31 (Suppl. 08) 529-531.