{"title":"射频消融与高位结扎剥脱治疗静脉曲张的回顾性分析。","authors":"Caijuan Geng, Yu Xie, Lifeng Zhang, Yao Lin, Junyu Zhang, Yuqian Xie, Wei Zeng","doi":"10.1016/j.avsg.2025.07.025","DOIUrl":null,"url":null,"abstract":"<p><strong>Objective: </strong>To compare the clinical efficacy, postoperative complications, and quality-of-life outcomes of ultrasound-guided radiofrequency ablation (RFA) combined with tributary phlebectomy and foam sclerotherapy versus high ligation and stripping (HLS) combined with tributary phlebectomy.</p><p><strong>Design: </strong>A single-center retrospective cohort study.</p><p><strong>Methods: </strong>We retrospectively analyzed 2,740 patients (1,588 women; mean age 59.01 ± 12.03 years) treated between October 2020 and October 2023. Among them, 1,756 (64.1%) underwent RFA and 984 (35.9%) underwent HLS. We assessed immediate success rate, 12-month recanalization, symptomatic recurrence, reintervention rate, and complications; The AVVQ and CIVIQ-14 scores were used to evaluate quality of life (QoL), while the VCSS was used to assess disease severity at 1, 6, and 12 months postoperatively.</p><p><strong>Results: </strong>Immediate success was achieved in both groups. At 12 months, the RFA group had 7 recanalizations (0.40%) versus 0 in the HLS group (P=0.112); symptomatic recurrence was 0.17% vs. 0.20% (P=1.000); reintervention rate was 2.62% vs. 3.05% (P=0.064); and each group had 2 cases of deep vein thrombosis. Minor complications in the HLS group included bruising (25.20% vs. 20.16%, P=0.002), pain (25.41% vs. 20.39%, P=0.002), and numbness (10.98% vs. 3.30%, P<0.001); the RFA group had higher induration (17.20% vs. 3.25%, P<0.001) and pigmentation (2.62% vs. 0.81%, P=0.001). Both groups showed significant improvements in AVVQ, VCSS, and CIVIQ-14 scores (P<0.05), with the RFA group demonstrating greater early improvement at 1 month.</p><p><strong>Conclusion: </strong>Ultrasound-guided RFA with foam sclerotherapy reduces minor complications such as pain, bruising, and numbness and significantly improves early quality of life, though it carries a higher risk of induration and pigmentation. Both RFA and HLS offer good long-term efficacy and low recurrence rates; treatment should be individualized based on patient condition and recovery needs.</p>","PeriodicalId":8061,"journal":{"name":"Annals of vascular surgery","volume":" ","pages":""},"PeriodicalIF":1.4000,"publicationDate":"2025-07-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":"{\"title\":\"Comparison of Radiofrequency Ablation and High Ligation Stripping for Varicose Veins: A Retrospective Analysis.\",\"authors\":\"Caijuan Geng, Yu Xie, Lifeng Zhang, Yao Lin, Junyu Zhang, Yuqian Xie, Wei Zeng\",\"doi\":\"10.1016/j.avsg.2025.07.025\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<p><strong>Objective: </strong>To compare the clinical efficacy, postoperative complications, and quality-of-life outcomes of ultrasound-guided radiofrequency ablation (RFA) combined with tributary phlebectomy and foam sclerotherapy versus high ligation and stripping (HLS) combined with tributary phlebectomy.</p><p><strong>Design: </strong>A single-center retrospective cohort study.</p><p><strong>Methods: </strong>We retrospectively analyzed 2,740 patients (1,588 women; mean age 59.01 ± 12.03 years) treated between October 2020 and October 2023. Among them, 1,756 (64.1%) underwent RFA and 984 (35.9%) underwent HLS. We assessed immediate success rate, 12-month recanalization, symptomatic recurrence, reintervention rate, and complications; The AVVQ and CIVIQ-14 scores were used to evaluate quality of life (QoL), while the VCSS was used to assess disease severity at 1, 6, and 12 months postoperatively.</p><p><strong>Results: </strong>Immediate success was achieved in both groups. At 12 months, the RFA group had 7 recanalizations (0.40%) versus 0 in the HLS group (P=0.112); symptomatic recurrence was 0.17% vs. 0.20% (P=1.000); reintervention rate was 2.62% vs. 3.05% (P=0.064); and each group had 2 cases of deep vein thrombosis. Minor complications in the HLS group included bruising (25.20% vs. 20.16%, P=0.002), pain (25.41% vs. 20.39%, P=0.002), and numbness (10.98% vs. 3.30%, P<0.001); the RFA group had higher induration (17.20% vs. 3.25%, P<0.001) and pigmentation (2.62% vs. 0.81%, P=0.001). Both groups showed significant improvements in AVVQ, VCSS, and CIVIQ-14 scores (P<0.05), with the RFA group demonstrating greater early improvement at 1 month.</p><p><strong>Conclusion: </strong>Ultrasound-guided RFA with foam sclerotherapy reduces minor complications such as pain, bruising, and numbness and significantly improves early quality of life, though it carries a higher risk of induration and pigmentation. Both RFA and HLS offer good long-term efficacy and low recurrence rates; treatment should be individualized based on patient condition and recovery needs.</p>\",\"PeriodicalId\":8061,\"journal\":{\"name\":\"Annals of vascular surgery\",\"volume\":\" \",\"pages\":\"\"},\"PeriodicalIF\":1.4000,\"publicationDate\":\"2025-07-22\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"Annals of vascular surgery\",\"FirstCategoryId\":\"3\",\"ListUrlMain\":\"https://doi.org/10.1016/j.avsg.2025.07.025\",\"RegionNum\":4,\"RegionCategory\":\"医学\",\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"\",\"PubModel\":\"\",\"JCR\":\"Q3\",\"JCRName\":\"PERIPHERAL VASCULAR DISEASE\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"Annals of vascular surgery","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.1016/j.avsg.2025.07.025","RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q3","JCRName":"PERIPHERAL VASCULAR DISEASE","Score":null,"Total":0}
引用次数: 0
摘要
目的：比较超声引导下射频消融（RFA）联合支静脉切除术和泡沫硬化治疗与高位结扎剥离（HLS）联合支静脉切除术的临床疗效、术后并发症和生活质量。设计：单中心回顾性队列研究。方法：回顾性分析2740例患者(女性1588例；平均年龄59.01±12.03岁，于2020年10月至2023年10月期间接受治疗。其中RFA 1756例（64.1%），HLS 984例（35.9%）。我们评估了即时成功率、12个月再通率、症状性复发、再干预率和并发症；AVVQ和CIVIQ-14评分用于评估生活质量（QoL），而VCSS用于评估术后1、6和12个月的疾病严重程度。结果：两组患者均取得立竿见影的效果。12个月时，RFA组有7例再通（0.40%），HLS组为0例（P=0.112）；症状复发率分别为0.17%和0.20% (P=1.000)；再干预率为2.62%比3.05% (P=0.064)；两组深静脉血栓形成2例。HLS组的轻微并发症包括瘀伤（25.20% vs. 20.16%， P=0.002）、疼痛（25.41% vs. 20.39%， P=0.002）、麻木（10.98% vs. 3.30%）。结论：超声引导RFA联合泡沫硬化治疗可减少疼痛、瘀伤、麻木等轻微并发症，显著改善早期生活质量，但存在较高的硬化和色素沉着风险。RFA和HLS长期疗效好，复发率低；治疗应根据病人的病情和康复需要进行个体化。
Comparison of Radiofrequency Ablation and High Ligation Stripping for Varicose Veins: A Retrospective Analysis.
Objective: To compare the clinical efficacy, postoperative complications, and quality-of-life outcomes of ultrasound-guided radiofrequency ablation (RFA) combined with tributary phlebectomy and foam sclerotherapy versus high ligation and stripping (HLS) combined with tributary phlebectomy.
Design: A single-center retrospective cohort study.
Methods: We retrospectively analyzed 2,740 patients (1,588 women; mean age 59.01 ± 12.03 years) treated between October 2020 and October 2023. Among them, 1,756 (64.1%) underwent RFA and 984 (35.9%) underwent HLS. We assessed immediate success rate, 12-month recanalization, symptomatic recurrence, reintervention rate, and complications; The AVVQ and CIVIQ-14 scores were used to evaluate quality of life (QoL), while the VCSS was used to assess disease severity at 1, 6, and 12 months postoperatively.
Results: Immediate success was achieved in both groups. At 12 months, the RFA group had 7 recanalizations (0.40%) versus 0 in the HLS group (P=0.112); symptomatic recurrence was 0.17% vs. 0.20% (P=1.000); reintervention rate was 2.62% vs. 3.05% (P=0.064); and each group had 2 cases of deep vein thrombosis. Minor complications in the HLS group included bruising (25.20% vs. 20.16%, P=0.002), pain (25.41% vs. 20.39%, P=0.002), and numbness (10.98% vs. 3.30%, P<0.001); the RFA group had higher induration (17.20% vs. 3.25%, P<0.001) and pigmentation (2.62% vs. 0.81%, P=0.001). Both groups showed significant improvements in AVVQ, VCSS, and CIVIQ-14 scores (P<0.05), with the RFA group demonstrating greater early improvement at 1 month.
Conclusion: Ultrasound-guided RFA with foam sclerotherapy reduces minor complications such as pain, bruising, and numbness and significantly improves early quality of life, though it carries a higher risk of induration and pigmentation. Both RFA and HLS offer good long-term efficacy and low recurrence rates; treatment should be individualized based on patient condition and recovery needs.
期刊介绍：
Annals of Vascular Surgery, published eight times a year, invites original manuscripts reporting clinical and experimental work in vascular surgery for peer review. Articles may be submitted for the following sections of the journal:
Clinical Research (reports of clinical series, new drug or medical device trials)
Basic Science Research (new investigations, experimental work)
Case Reports (reports on a limited series of patients)
General Reviews (scholarly review of the existing literature on a relevant topic)
Developments in Endovascular and Endoscopic Surgery
Selected Techniques (technical maneuvers)
Historical Notes (interesting vignettes from the early days of vascular surgery)
Editorials/Correspondence
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