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Int J Surg. 2017 Mar;39:267-275. doi: 10.1016/j.ijsu.2017.01.080. Epub 2017 Jan 21.

Comparison of ultrasound-guided endovenous laser ablation and radiofrequency for the varicose veins treatment: An updated meta-analysis.

Author information

1
Department of Ultrasound, Shenzhen Guangming New District People's Hospital, 339# Songbai Road, Gongming Street, Shenzhen 518106, China.
2
No. 2 Clinic, Logistic Support Department, Central Military Commission, Beijing 100071, China.
3
Interventional Ultrasound Center, China-Japan Friendship Hospital, East Yinghua Street, Hepingli, Beijing 100029, China. Electronic address: yma301@163.com.
4
Department of Vascular and Endovascular Surgery, Chinese PLA General Hospital, Beijing 100853, China.

Abstract

PURPOSE:

To investigate and compare the relative efficacy, recurrence and complications of endovenous laser ablation (EVLA) and radiofrequency ablation (RFA) for the treatment of varicose veins patients.

METHODS:

Searches were applied to the Cochrane Library as well as MEDLINE, EMBASE, BIOSIS databases. 12 articles published in English (10 randomized controlled trials and 2 cohort study) were identified from specialized trails. Fixed effect model and Random effect model were applied to compare the vein ablated length, pain scores (3days and 10days), quality of Life, occlusion, over all complication, thrombophlebitis, haematoma and recanalization between the EVLA and RFA group. The results were expressed as odds ratio (OR) or relative risk (RR) and 95% confidence intervals (CI) for categorical outcomes.

RESULTS:

12 reported studies with a combined total of 1577 patients were included. vein ablated length (SMD:0.37, 95%CI: 0.04 to 0.77), 3days pain scores (SMD:11.25, 95%CI: 3.42 to 25.92) and 10days (SMD:0.79,95%CI: 0.48 to 2.05),1 month quality of Life (SMD: 0.09,95%CI: 0.28 to 0.10) and 1 year (SMD: 0.04,95%CI: 0.21 to 0.13), occlusion (OR:1.05,95%CI:0.41 to 2.73), thrombophlebitis (RR:1.03,95%CI:0.56 to 1.92), haematoma (OR:1.55, 95%CI:0.54 to 4.45) and recanalization (OR:0.68,95%CI:0.43 to 1.09) following RFA showed no difference when compared with EVLA. These results were not statistically significant. RFA was associated with the lower overall complication (OR: 3.49, 95%CI:1.36 to 8.96) in patients with varicose veins compared to the EVLA treatment.

CONCLUSION:

EVLA and RFA seem to be the same safe and effective on clinical efficacy (vein ablated length, 3days and 10days pain scores, 1 month and 1 year quality of life, occlusion, thrombophlebitis, haematoma and recanalization). Data on RFA seems to having potential benefits from reducing risk of overall complication than EVLA, which is needed by large high-quality prospective randomized trials.

KEYWORDS:

Endovenous laser ablation; Meta-analysis; Radio frequency; Ultrasound; Varicose vein

PMID:
28119106
DOI:
10.1016/j.ijsu.2017.01.080
[Indexed for MEDLINE]
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