Shear wave elastography of dermal stiffness after radiofrequency ablation for great saphenous vein reflux: A 12-month prospective study.

Abstract

ObjectivesTo evaluate longitudinal changes in dermal tissue stiffness measured by shear wave elastography (SWE) following radiofrequency ablation (RFA) of the great saphenous vein (GSV) and to examine the relationship between tissue-level and clinical recovery in chronic venous insufficiency (CVI).MethodsThis prospective cohort study enrolled 47 patients (55 extremities, including 8 bilateral cases) who underwent endovenous RFA for grade 4 GSV reflux between May and December 2022. SWE measurements were obtained preoperatively and at 3 and 12 months using a standardized protocol (Canon Aplio 500, lateral calf at a fixed anatomical reference). Longitudinal changes were analyzed using generalized estimating equations (GEE) on log-transformed values with robust standard errors. Spearman correlations between SWE and Venous Clinical Severity Score (VCSS) were examined.ResultsMean SWE values were 19.13 ± 9.81 kPa preoperatively, 18.62 ± 10.10 kPa at 3 months (Holm-adjusted p = 0.669), and 11.30 ± 6.62 kPa at 12 months (p < 0.001). VCSS decreased from 4.04 ± 1.60 to 0.78 ± 0.74 (p < 0.001). VCSS and SWE were moderately associated at 12 months (ρ = 0.499, adjusted p < 0.001), whereas their changes were not significantly associated (ρ = 0.125, 95% CI -0.148 to 0.380; p = 0.37).ConclusionsThese results enhance the current literature by indicating that SWE demonstrated a delayed decrease in dermal stiffness after radiofrequency ablation and may provide complementary quantitative information on tissue-level changes not assessed by Doppler ultrasonography. Although not yet suitable for standard clinical use, SWE shows potential as an additional follow-up tool in chronic venous insufficiency.