The Impact of Endovenous Thermal Ablation on Venous Leg Ulcer Healing
Mehdi Eslami, Ahmed Kayssi, MD, Homayoun Hashemi, MD, Kapil Gopal, MD, Richard Neville, MD, Dipankar Mukherjee, MD.
Inova Fairfax, Falls Church, VA, USA.
Objective(s): The role of endovenous thermal ablation modalities, such as radio-frequency ablation (RFA) of the saphenous veins, in the treatment of active venous ulcers remains unclear. The aim of this study was to assess the impact of endovenous thermal ablation on venous leg ulcer healing.
Methods: A retrospective chart review was carried out of all patients undergoing radiofrequency ablation (RFA) at a single institution for active venous leg ulcers in the years 2015-2017. Baseline patient characteristics, healing rates, and time to healing were assessed.
Results: Thirty-seven patients were identified. The majority were male (68%), and the median age was 65 years (range: 33-95). All ulcers were refractory to treatment by a wound care specialist, and the median duration of wounds prior to RFA treatment was 6 months (range: 1 to 120). Venous leg ulcers were present on the left (54%) and right (41%) legs, and bilaterally (5%). The great saphenous vein (68%), short saphenous vein (14%), and both great and short saphenous veins (19%) were treated, where evidence of reflux was present. Three patients (8%) had undergone prior venous therapies on the affected limb. Complete ulcer healing occurred in 72% of patients, at a median of 2 months after the procedure (range: 0.25-8).
Conclusions: RFA therapy is beneficial in successfully treating active venous ulcers in some patients. A prospective randomized controlled trial is needed to adequately assess whether this treatment modality should become a standard of care in this patient population.
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