Background: Despite adequate training in the surgical treatment of varicose veins, recurrence continues to be a problem and a burden to the vascular services. A major cause of recurrence is reported to be neo-vascularisation at the sapheno-femoral junction (SFJ). The aim of this study was to compare the incidence of neo-vascularisation at the SFJ following radiofrequency ablation (RFA) and open high saphenous tie and stripping (HSTS).
Materials and methods: Fifty-one patients (55 legs) underwent standardised HSTS as part of a prospective study. These were compared with an age (range 28-83, mean 54.4) and sex (male:female 31:20) matched group of patients treated during the same time period, by the same consultant vascular surgeon, using RFA (VNUS closure). Each patient had a pre-operative duplex scan to confirm SFJ reflux, a one-week scan to confirm successful surgery and a one-year post-operative scan to assess neo-vascularisation. The same vascular technologist performed all scans. Neo-vascularisation was identified by the presence of refluxing tortuous vessels arising from the area of the SFJ.
Results and conclusion: Six of 55 (11%) legs in the open surgery group showed clear evidence of tortuous refluxing veins related to the SFJ. None of the 55 in the RFA group showed any neo-vascularisation at the SFJ (Fischer exact test P = 0.028). Further randomised controlled trials are necessary to confirm these observations.