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The utility of the Venous Clinical Severity Score in 682 limbs treated by radiofrequency saphenous vein ablation.
J Vasc Surg. 2007 May; 45(5):1008-1014; discussion 1015.JV

Abstract

OBJECTIVES

The goal of endovenous ablation is to reduce the symptoms associated with chronic venous insufficiency. This prospective study was designed to apply the venous clinical severity score to limbs before and after endovenous saphenous vein radiofrequency ablation and to identify risk factors associated with treatment failure.

METHODS

Between September 2003 and March 2005, 499 patients underwent 682 saphenous vein radiofrequency ablation procedures. Preoperative venous clinical severity scores were documented. Follow-up clinical and duplex examinations were performed at 4 days, 4 weeks, and 4 months after saphenous vein radiofrequency ablation and at > or=6 months thereafter. Venous clinical severity scoring was repeated at follow-up visits, and patients were asked to evaluate their level of satisfaction with the procedure.

RESULTS

The mean +/- standard deviation age of the patients was 53.5 +/- 13.3 years (range, 28 to 86 years), and 68% were women. Pretreatment CEAP clinical class C3/C4 comprised 80% of limbs (520/682). Preoperative, 4-day, 4-week, and 4-month venous clinical severity scores were, respectively, 8.8 +/- 3.7 in 648 limbs, 5.2 +/- 3.0 in 629, 4.1 +/- 2.4 in 530, and 3.3 +/- 1.6 in 479 limbs. Saphenous vein radiofrequency ablation significantly reduced pain related to lower extremity venous disease from 95.7% to 15.2% (P < .0001) and edema from 92.4% to 17.0% (P < .0001). Before treatment, venous stasis ulcers were present in 52 limbs and healed at a rate of 86%. Complications in 633 limbs at last follow-up included superficial thrombophlebitis in 12.0%, paresthesia in 0.3%, and nonocclusive thrombus extension in 0.2%. No skin thermal injury was observed. Fewer than 2% of patients reported dissatisfaction with their procedural outcome. Age (relative risk, 0.98; P = .06), female sex (relative risk, 0.19; P < .0001), and tumescent volume >250 mL (relative risk, 0.59; P = .06) were associated with higher rates of occlusion. The overall occlusion rate was 87.1%.

CONCLUSIONS

As determined by the venous clinical severity score, treatment of saphenous vein reflux with endovenous radiofrequency ablation results in the clinical improvement of symptoms and aids in the healing of venous ulcers. Age, female sex, and tumescent volume are associated with high success rates of occlusion. We found the venous clinical severity score to be an excellent stand-alone tool for assessing outcomes after saphenous vein radiofrequency ablation.

Authors+Show Affiliations

Department of Surgery, State University of New York at Buffalo, Buffalo, NY 14120, USA. MVasquezMD@adelphia.net <MVasquezMD@adelphia.net>No affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Evaluation Study
Journal Article

Language

eng

PubMed ID

17466795

Citation

Vasquez, Michael A., et al. "The Utility of the Venous Clinical Severity Score in 682 Limbs Treated By Radiofrequency Saphenous Vein Ablation." Journal of Vascular Surgery, vol. 45, no. 5, 2007, pp. 1008-1014; discussion 1015.
Vasquez MA, Wang J, Mahathanaruk M, et al. The utility of the Venous Clinical Severity Score in 682 limbs treated by radiofrequency saphenous vein ablation. J Vasc Surg. 2007;45(5):1008-1014; discussion 1015.
Vasquez, M. A., Wang, J., Mahathanaruk, M., Buczkowski, G., Sprehe, E., & Dosluoglu, H. H. (2007). The utility of the Venous Clinical Severity Score in 682 limbs treated by radiofrequency saphenous vein ablation. Journal of Vascular Surgery, 45(5), 1008-1014; discussion 1015.
Vasquez MA, et al. The Utility of the Venous Clinical Severity Score in 682 Limbs Treated By Radiofrequency Saphenous Vein Ablation. J Vasc Surg. 2007;45(5):1008-1014; discussion 1015. PubMed PMID: 17466795.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - The utility of the Venous Clinical Severity Score in 682 limbs treated by radiofrequency saphenous vein ablation. AU - Vasquez,Michael A, AU - Wang,Jiping, AU - Mahathanaruk,Marchyan, AU - Buczkowski,Glenn, AU - Sprehe,Esther, AU - Dosluoglu,Hasan H, PY - 2006/10/03/received PY - 2006/12/21/accepted PY - 2007/5/1/pubmed PY - 2007/5/26/medline PY - 2007/5/1/entrez SP - 1008-1014; discussion 1015 JF - Journal of vascular surgery JO - J Vasc Surg VL - 45 IS - 5 N2 - OBJECTIVES: The goal of endovenous ablation is to reduce the symptoms associated with chronic venous insufficiency. This prospective study was designed to apply the venous clinical severity score to limbs before and after endovenous saphenous vein radiofrequency ablation and to identify risk factors associated with treatment failure. METHODS: Between September 2003 and March 2005, 499 patients underwent 682 saphenous vein radiofrequency ablation procedures. Preoperative venous clinical severity scores were documented. Follow-up clinical and duplex examinations were performed at 4 days, 4 weeks, and 4 months after saphenous vein radiofrequency ablation and at > or=6 months thereafter. Venous clinical severity scoring was repeated at follow-up visits, and patients were asked to evaluate their level of satisfaction with the procedure. RESULTS: The mean +/- standard deviation age of the patients was 53.5 +/- 13.3 years (range, 28 to 86 years), and 68% were women. Pretreatment CEAP clinical class C3/C4 comprised 80% of limbs (520/682). Preoperative, 4-day, 4-week, and 4-month venous clinical severity scores were, respectively, 8.8 +/- 3.7 in 648 limbs, 5.2 +/- 3.0 in 629, 4.1 +/- 2.4 in 530, and 3.3 +/- 1.6 in 479 limbs. Saphenous vein radiofrequency ablation significantly reduced pain related to lower extremity venous disease from 95.7% to 15.2% (P < .0001) and edema from 92.4% to 17.0% (P < .0001). Before treatment, venous stasis ulcers were present in 52 limbs and healed at a rate of 86%. Complications in 633 limbs at last follow-up included superficial thrombophlebitis in 12.0%, paresthesia in 0.3%, and nonocclusive thrombus extension in 0.2%. No skin thermal injury was observed. Fewer than 2% of patients reported dissatisfaction with their procedural outcome. Age (relative risk, 0.98; P = .06), female sex (relative risk, 0.19; P < .0001), and tumescent volume >250 mL (relative risk, 0.59; P = .06) were associated with higher rates of occlusion. The overall occlusion rate was 87.1%. CONCLUSIONS: As determined by the venous clinical severity score, treatment of saphenous vein reflux with endovenous radiofrequency ablation results in the clinical improvement of symptoms and aids in the healing of venous ulcers. Age, female sex, and tumescent volume are associated with high success rates of occlusion. We found the venous clinical severity score to be an excellent stand-alone tool for assessing outcomes after saphenous vein radiofrequency ablation. SN - 0741-5214 UR - https://www.unboundmedicine.com/medline/citation/17466795/The_utility_of_the_Venous_Clinical_Severity_Score_in_682_limbs_treated_by_radiofrequency_saphenous_vein_ablation_ L2 - https://linkinghub.elsevier.com/retrieve/pii/S0741-5214(07)00011-0 DB - PRIME DP - Unbound Medicine ER -