Journal
VASCULAR
Volume 30, Issue 2, Pages 357-364Publisher
SAGE PUBLICATIONS LTD
DOI: 10.1177/17085381211010022
Keywords
Post-phelebtic venous ulcers; incompetent perforators; radiofrequency ablation; compression therapy; venous reflux; endovenous perforator surgery
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The study demonstrates that radiofrequency ablation for incompetent perforators is more effective than conventional compression therapy in terms of healing time and ulcer recurrence for patients with Venus ulcers caused by incompetent perforating veins.
Background Venus ulcers developed mainly due to reflux of incompetent venous valves in perforating veins. Patients and methods In this randomized controlled trial, 119 patients recruited over two years, with post-phelebtic venous leg ulcers, were randomly assigned into one of two groups: either to receive radiofrequency ablation of markedly incompetent perforators (Group A, n = 62 patients) or to receive conventional compression therapy (Group B, n = 57 patients). Follow-up duration required for ulcer healing continued for 24 months post randomization. Results Statistically significant shorter time to healing (ulcer complete healing or satisfactory clinical improvement) between both groups (56 patients, 90.3% of cases in Group A versus 44 patients 77.2% of cases in Group B) over the follow-up period of 24 months was attained (p = 0.001). Also, significantly different ulcer recurrence was recorded between both groups, 8 patients (12.9%) in Group A versus 19 patients (33.3%) in Group B (p = 0.004). Conclusion In absence of deep venous obstruction, the monopolar radiofrequency ablation for incompetent perforators is a feasible and effective method that surpasses the traditional compression protocol for incompetent perforator-induced venous ulcers in terms of time required for healing even in the presence of unresolved deep venous valvular reflux.
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