PHLEBOLOGY 2015 Sep;30(8):525-32. doi: 10.1177/0268355514540882. Epub 2014 Jun 18.
Thermal ablation of saphenous veins is feasible and safe in patients older than 75 years: A prospective study (EVTA study).
Allouche L, Néaume N, Bammatter JP, Bourgeois L, Bracon JF, Burcheri B, Ravelojaona M, Cales B, Chauzat B, Ducrey N, Gracia S, Gueddi S, Hamel-Desnos C, Desnos P, Hévia M, Kern P, Merminod T, Ouvry P, Poulain C, Sintes P, Lampel M, Thiên QT
To investigate the tolerance and safety of thermal ablation (TA), consisting of radiofrequency or endovenous laser (EVLA) of saphenous veins (SV) in elderly (group 1 ≥75 years), compared with a control group (group 2 <75 years).
An Observational multicenter-prospective study was conducted, under the aegis of the French and Swiss Societies of Phlebology (18 centers). Ninety patients were included in group 1, 617 in group 2 (mean age 80 years and 53 years; 69% women in both groups), representing 863 SV. Mean trunk diameters were similar in both groups (small SV: 6 mm; great SV: 7 mm). In group 1, comorbidities were more frequent, particularly cardiac insufficiency, diabetes, history of thrombosis, and CEAP clinical class was significantly higher.
EVLA was used in 86% of cases. Settings used were similar in both groups for each technique. Only 6% of TA was performed in an operating room for group 1 (14% group 2). Tumescent local anaesthesia (TLA) alone was used in 91% of cases in group 1 (85% group 2). The mean pain score was only 1.6 for the procedure itself (VASP 0-10; 10 max.) and 1.4 for the 10 days following the procedure. Side effects were few, but rate of paraesthesia was higher when general anaesthesia was used (11.8%) compared with TLA alone (2.2%). At three months, 100% of SV was occluded in group 1 (99.5% group 2), with high satisfaction score (9.3/10).
TA is safe and effective in elderly; it should be performed strictly under TLA to minimize side effects.