Radiofrequency Ablation as Effective as Laser for Treating Varicose Veins

A new study has found that radiofrequency ablation (RFA) is similarly effective to endovenous laser ablation (EVLA) for varicose veins, but causes less postprocedural pain.

Researchers at Charing Cross Hospital (London, United Kingdom) conducted a randomized controlled trial involving 131 consecutive patients with primary great saphenous vein reflux who were randomly assigned to either EVLA or RFA. The main study endpoint was postprocedural pain after 3 days, as measured on a graphic scale; secondary endpoints were quality of life (QOL) at 6 weeks, Aberdeen Varicose Vein Questionnaire, Short Form 12, and clinical improvement as measured by the Venous Clinical Severity Score (VCSS). Multivariable linear regression analyses were based on intention to treat.

The researchers found that after 3 days, mean pain scores were 26.4 mm for RFA and 36.8 for EVLA; over 10 days, the mean scores were 22.0 mm for RFA and 34 mm, respectively. When compared with to the EVLA group, the RFA group used a lower mean number of analgesic tablets for the entire period. Both groups had similar changes in Aberdeen Varicose Vein Questionnaire, Short Form 12, and VCSS scores at 6 weeks. The study was published in the June 2010 issue of the British Journal of Surgery.

"Endovenous laser ablation and RFA are both associated with excellent technical, clinical, and patient-reported outcomes for the treatment of varicose veins,” concluded lead author Amanda Shepherd, M.D., and colleagues of the Imperial Vascular Unit. "The aim of this study was to compare the techniques in a randomized clinical trial.”

To reduce the postprocedural discomfort associated with EVLA, newer radial fibers, longer wavelengths and jacketed laser fibers have been developed that have been shown to be associated with low post-intervention pain scores, and are therefore likely to soon replace the 980-nm bare-tip laser fiber.

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Charing Cross Hospital