Minimally invasive management of chronic venous insufficiency: A case report on combined radiofrequency ablation and sclerotherapy in an obese patient

Introduction

Chronic venous insufficiency (CVI) affects a significant portion of the population, particularly impacting those with obesity. This condition leads to various symptoms, including leg discomfort and edema, contributing to work absenteeism. Traditional surgical procedures, like saphenous vein stripping and phebectomy, are increasingly supplanted by minimally invasive techniques, such as radiofrequency ablation (RFA) and sclerotherapy, which reduce invasiveness and associated complications, particularly beneficial for high-risk patients, including those with obesity.

Case presentation

A 22-year-old male patient with a BMI of 41, suffering from severe varicose veins, hypertension, diabetes, and obstructive sleep apnea. The patient underwent simultaneous RFA and sclerotherapy after imaging confirmed significant venous incompetence but ruled out deep vein thrombosis. The procedure, performed under spinal anesthesia, resulted in successful obliteration of the great saphenous vein, with no postoperative complications.

Clinical discussion

The literature highlights the advantages of endovascular techniques over traditional open surgery, particularly for patients with comorbidities that elevate surgical risks. Studies support the efficacy of combining RFA with sclerotherapy, showing improved outcomes and reduced recurrence rates. This combined approach minimizes complications and provides a quicker recovery, making it a suitable option for high-risk patients.

Conclusion

Our experience and the findings of literature suggest that radiofrequency ablation paired with sclerotherapy is an effective treatment modality for managing CVI, particularly in patients with obesity.