-One-Year Clinical and Patient-Reported Outcomes After Endovenous Radiofrequency Ablation for Varicose Veins: A Prospective Cohort Study
Abstract
Background: Endo-Venous Radio-Frequency Ablation (EVRF) is widely used for treating varicose veins, offering a minimally invasive alternative to traditional surgery. However, the trajectory of postoperative symptoms, recurrence patterns, and patient-centered outcomes remains variable across populations.
Objective: To evaluate postoperative symptom changes, vein occlusion patterns, recurrence, cutaneous effects, patient satisfaction, and quality of life in patients undergoing EVRF over a one-year follow-up period.
Methods: A prospective observational study was conducted on 125 patients treated with EVRF in Dijlah Privet Hospital, Miysan, Iraq. Clinical outcomes—including paresthesia, thrombophlebitis, ecchymosis, redness and skin changes, cellulitis, recurrence, occlusion rate, patient satisfaction, and quality of life—were assessed using a standardized four-point scoring system. Evaluations were performed at week one, 30 days, and one year. Paired t-tests were applied to compare temporal changes.
Results: Significant early improvements were observed across most clinical indicators. Paresthesia decreased from 1.3462 at week one to 1.0692 at 30 days (p < 0.001). Redness, skin changes, thrombophlebitis, and ecchymosis demonstrated similar reductions. Recurrence improved significantly from 0.9846 to 0.6769 at one year (p < 0.001). In contrast, occlusion scores declined from 2.8846 at week one to 1.9231 at one year (p < 0.001), suggesting partial recanalization. Quality-of-life scores improved significantly from 3.6154 to 2.4154 (p < 0.001). Despite these objective improvements, patient satisfaction decreased from 2.8154 to 1.8538 over the same period (p < 0.001). Cellulitis showed no significant change (p = 0.074).
Conclusion: EVRF provides substantial early postoperative benefits and long-term improvements in quality of life, with low complication rates. However, reduced occlusion durability and declining patient satisfaction highlight the importance of standardized imaging follow-up and enhanced patient counseling to optimize long-term outcomes.
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7. Kaur M, Kaur S. Concept of quality of life in health care research: a review. Int J Community Med Public Health. 2023;10(10).
8. Alemi F, Azimi M, Moeini R, Shirafkan H, Bayani M, Mojahedi M, et al. The Effectiveness of Leech Therapy in the Severity of Diabetic Neuropathy: A Randomized Controlled Trial. Traditional and Integrative Medicine. 2022;7(4).
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12. Bontinis V, Bontinis A, Koutsoumpelis A, Potouridis A, Giannopoulos A, Rafailidis V, et al. Endovenous thermal ablation in the treatment of large great saphenous veins of diameters > 12 mm: A systematic review meta-analysis and meta-regression. Vascular Medicine (United Kingdom). 2023;28(5).
13. Athavale A, Thao M, Sassaki VS, Lewis M, Chandra V, Fukaya E. Cyanoacrylate glue reactions: A systematic review, cases, and proposed mechanisms. J Vasc Surg Venous Lymphat Disord [Internet]. 2023 Jul 1 [cited 2025 Dec 5];11(4):876. Available from: https://pmc.ncbi.nlm.nih.gov/articles/PMC12433822/
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15. Lim H, Kim MJ. Long-Term Outcomes of Radiofrequency Ablation in Patients with Low-Risk Papillary Thyroid Microcarcinoma. Endocrinology and Metabolism [Internet]. 2025 Jun 1 [cited 2025 Dec 5];40(3):385–7. Available from: https://www.researchgate.net/publication/392624086_Long-Term_Outcomes_of_Radiofrequency_Ablation_in_Patients_with_Low-Risk_Papillary_Thyroid_Microcarcinoma
16. Dermody M, O’Donnell TF, Balk EM. The study examined the complications associated with endovenous ablation in randomized controlled trials. J Vasc Surg Venous Lymphat Disord [Internet]. 2013 Oct 1 [cited 2025 Dec 5];1(4):427-436.e1. Available from: https://www.sciencedirect.com/science/article/pii/S2213333X1300053X?utm_source=chatgpt.com
17. Jiang W, Liang Y, Long Z, Hu M, Yang H, Qin X. Endovenous radiofrequency ablation vs laser ablation in patients with lower extremity varicose veins: A meta-analysis. J Vasc Surg Venous Lymphat Disord [Internet]. 2024 Sep 1 [cited 2025 Dec 5];12(5). Available from: https://www.jvsvenous.org/action/showFullText?pii=S2213333X24001288
18. Baccellieri D, Ardita V, Pannone A, Valente FBA, Lembo R, Chiesa R, et al. Factors influencing recurrent varicose vein formation after radiofrequency thermal ablation for truncal reflux performed in two high-volume venous centers. J Vasc Surg Venous Lymphat Disord [Internet]. 2024 Mar 1 [cited 2025 Dec 5];12(2):101675. Available from: https://www.sciencedirect.com/science/article/pii/S2213333X23003268?utm_source=chatgpt.com
19. A retrospective study of 100 patients with varicose veins treated with radiofrequency ablation and stripping - Servier - PhlebolymphologyServier – Phlebolymphology [Internet]. [cited 2025 Dec 5]. Available from: https://www.phlebolymphology.org/a-retrospective-study-of-100-patients-with-varicose-veins-treated-with-radiofrequency-ablation-and-stripping/?utm_source=chatgpt.com
20. Choi JH, Park HC, Joh JH. The occlusion rate and patterns of saphenous vein after radiofrequency ablation. J Korean Surg Soc. 2013;84(2).
21. Pannone A, Di Girolamo A, Orrico M, Mangialardi N. Outcome Measures of In-Office Endovenous Radiofrequency Treatment of Varicose Vein Feasibility. Diagnostics. 2023 Jan 1;13(2).
22. Toz H, Kuserli Y. Comparison of long-term outcomes and quality of life following radiofrequency ablation, endovenous laser ablation, and N-butyl cyanoacrylate treatment of greater saphenous vein insufficiency. J Vasc Surg Venous Lymphat Disord [Internet]. 2026 Jan 1 [cited 2025 Dec 5];14(1):102316. Available from: https://www.sciencedirect.com/science/article/pii/S2213333X25001519?utm_source=chatgpt.com
23. Kusagawa H. Clinical Results 5 Years after Radiofrequency Ablation of Saphenous Veins. Ann Vasc Dis [Internet]. 2025 [cited 2025 Dec 5];18(1):25–00097. Available from: https://pmc.ncbi.nlm.nih.gov/articles/PMC12436687/
24. Rasmussen L, Lawaetz M, Serup J, Bjoern L, Vennits B, Blemings A, et al. Randomized clinical trial comparing endovenous laser ablation, radiofrequency ablation, foam sclerotherapy, and surgical stripping for great saphenous varicose veins with 3-year follow-up. J Vasc Surg Venous Lymphat Disord [Internet]. 2013 [cited 2025 Dec 5];1(4):349–56. Available from: https://pubmed.ncbi.nlm.nih.gov/26992754/
25. Brittenden J, Cooper D, Dimitrova M, Scotland G, Cotton SC, Elders A, et al. Five-Year Outcomes of a Randomized Trial of Treatments for Varicose Veins. New England Journal of Medicine [Internet]. 2019 Sep 5 [cited 2025 Dec 5];381(10):912–22. Available from: https://www.nejm.org/doi/pdf/10.1056/NEJMoa1805186
26. Turkish Journal of Thoracic and Cardiovascular Surgery [Internet]. [cited 2025 Dec 5]. Available from: https://tjtcvs.com/
27. Hartmann K, Gholam P, Dietrich C, Fink C. Efficacy and safety of endovenous laser ablation with the 1470 nm diode laser using a novel optical probe. Int J Med Sci. 2022;19(4).
28. Hamann SAS, Timmer-de Mik L, Fritschy WM, Kuiters GRR, Nijsten TEC, van den Bos RR. Randomized Clinical Trial of Endovenous Laser Ablation Versus Direct and Indirect Radiofrequency Ablation for the Treatment of Great Saphenous Varicose Veins. J Vasc Surg Venous Lymphat Disord [Internet]. 2019 Sep 1 [cited 2025 Dec 5];7(5):763–4. Available from: https://www.jvsvenous.org/action/showFullText?pii=S2213333X19303439
2. Sierra-Juárez MA, Rejón-Cauich JE, Parada-Guzmán MG, Castañeda-Morales SA, Sierra-Juárez MA, Rejón-Cauich JE, et al. Chronic venous disease: Literature review. Revista médica del Hospital General de México [Internet]. 2021 Apr 26 [cited 2025 Dec 4];84(2):80–6. Available from: http://www.scielo.org.mx/scielo.php?script=sci_arttext&pid=S2524-177X2021000200080&lng=es&nrm=iso&tlng=en
3. Cong L, Sun J, Wang L, Han Y, Dong J, Cao Y, et al. Hybrid endovenous laser ablation reduces the recurrence of varicose veins below the knee compared with radiofrequency ablation: a real-world study. Archives of Medical Science [Internet]. 2023 Nov 13 [cited 2025 Dec 4];19(6):1739–46. Available from: https://www.archivesofmedicalscience.com/Hybrid-endovenous-laser-ablation-reduces-the-recurrence-of-varicose-veins-below-the,163449,0,2.html
4. Sevil F, Colak A, Ceviz M, Kaya U, Becit N. The Effectiveness of Endovenous Radiofrequency Ablation Application in Varicose Vein Diseases of the Lower Extremity. Cureus. 2020 Apr 11;
5. Hew CY, McElvenny DM, Onwudike M. Longer term follow-up of a randomized controlled trial on the role of compression after radiofrequency ablation of varicose veins. J Vasc Surg Venous Lymphat Disord [Internet]. 2024 Jan 1 [cited 2025 Dec 4];13(1):101963. Available from: https://pmc.ncbi.nlm.nih.gov/articles/PMC11764723/
6. Brittenden J, Cooper D, Dimitrova M, Scotland G, Cotton SC, Elders A, et al. Five-Year Outcomes of a Randomized Trial of Treatments for Varicose Veins. New England Journal of Medicine. 2019 Sep 5;381(10):912–22.
7. Kaur M, Kaur S. Concept of quality of life in health care research: a review. Int J Community Med Public Health. 2023;10(10).
8. Alemi F, Azimi M, Moeini R, Shirafkan H, Bayani M, Mojahedi M, et al. The Effectiveness of Leech Therapy in the Severity of Diabetic Neuropathy: A Randomized Controlled Trial. Traditional and Integrative Medicine. 2022;7(4).
9. Brindle RJ, O’Neill LA, Williams OM. Risk, Prevention, Diagnosis, and Management of Cellulitis and Erysipelas. Vol. 9, Current Dermatology Reports. 2020.
10. Thrombophlebitis: a case study [Internet]. [cited 2025 Dec 4]. Available from: https://www.homeobook.com/thrombophlebitis-a-case-study/
11. Zuhier Qasim Almomani R, Risheed Al-Ghdabi R, Mohammad Bany-hamdan K. Patients’ satisfaction of health service quality in public hospitals: A PubHosQual analysis. Management Science Letters. 2020;10:1803–12.
12. Bontinis V, Bontinis A, Koutsoumpelis A, Potouridis A, Giannopoulos A, Rafailidis V, et al. Endovenous thermal ablation in the treatment of large great saphenous veins of diameters > 12 mm: A systematic review meta-analysis and meta-regression. Vascular Medicine (United Kingdom). 2023;28(5).
13. Athavale A, Thao M, Sassaki VS, Lewis M, Chandra V, Fukaya E. Cyanoacrylate glue reactions: A systematic review, cases, and proposed mechanisms. J Vasc Surg Venous Lymphat Disord [Internet]. 2023 Jul 1 [cited 2025 Dec 5];11(4):876. Available from: https://pmc.ncbi.nlm.nih.gov/articles/PMC12433822/
14. O’Donnell TF, Balk EM, Dermody M, Tangney E, Iafrati MD. Recurrence of varicose veins after endovenous ablation of the great saphenous vein in randomized trials. Vol. 4, Journal of Vascular Surgery: Venous and Lymphatic Disorders. 2016.
15. Lim H, Kim MJ. Long-Term Outcomes of Radiofrequency Ablation in Patients with Low-Risk Papillary Thyroid Microcarcinoma. Endocrinology and Metabolism [Internet]. 2025 Jun 1 [cited 2025 Dec 5];40(3):385–7. Available from: https://www.researchgate.net/publication/392624086_Long-Term_Outcomes_of_Radiofrequency_Ablation_in_Patients_with_Low-Risk_Papillary_Thyroid_Microcarcinoma
16. Dermody M, O’Donnell TF, Balk EM. The study examined the complications associated with endovenous ablation in randomized controlled trials. J Vasc Surg Venous Lymphat Disord [Internet]. 2013 Oct 1 [cited 2025 Dec 5];1(4):427-436.e1. Available from: https://www.sciencedirect.com/science/article/pii/S2213333X1300053X?utm_source=chatgpt.com
17. Jiang W, Liang Y, Long Z, Hu M, Yang H, Qin X. Endovenous radiofrequency ablation vs laser ablation in patients with lower extremity varicose veins: A meta-analysis. J Vasc Surg Venous Lymphat Disord [Internet]. 2024 Sep 1 [cited 2025 Dec 5];12(5). Available from: https://www.jvsvenous.org/action/showFullText?pii=S2213333X24001288
18. Baccellieri D, Ardita V, Pannone A, Valente FBA, Lembo R, Chiesa R, et al. Factors influencing recurrent varicose vein formation after radiofrequency thermal ablation for truncal reflux performed in two high-volume venous centers. J Vasc Surg Venous Lymphat Disord [Internet]. 2024 Mar 1 [cited 2025 Dec 5];12(2):101675. Available from: https://www.sciencedirect.com/science/article/pii/S2213333X23003268?utm_source=chatgpt.com
19. A retrospective study of 100 patients with varicose veins treated with radiofrequency ablation and stripping - Servier - PhlebolymphologyServier – Phlebolymphology [Internet]. [cited 2025 Dec 5]. Available from: https://www.phlebolymphology.org/a-retrospective-study-of-100-patients-with-varicose-veins-treated-with-radiofrequency-ablation-and-stripping/?utm_source=chatgpt.com
20. Choi JH, Park HC, Joh JH. The occlusion rate and patterns of saphenous vein after radiofrequency ablation. J Korean Surg Soc. 2013;84(2).
21. Pannone A, Di Girolamo A, Orrico M, Mangialardi N. Outcome Measures of In-Office Endovenous Radiofrequency Treatment of Varicose Vein Feasibility. Diagnostics. 2023 Jan 1;13(2).
22. Toz H, Kuserli Y. Comparison of long-term outcomes and quality of life following radiofrequency ablation, endovenous laser ablation, and N-butyl cyanoacrylate treatment of greater saphenous vein insufficiency. J Vasc Surg Venous Lymphat Disord [Internet]. 2026 Jan 1 [cited 2025 Dec 5];14(1):102316. Available from: https://www.sciencedirect.com/science/article/pii/S2213333X25001519?utm_source=chatgpt.com
23. Kusagawa H. Clinical Results 5 Years after Radiofrequency Ablation of Saphenous Veins. Ann Vasc Dis [Internet]. 2025 [cited 2025 Dec 5];18(1):25–00097. Available from: https://pmc.ncbi.nlm.nih.gov/articles/PMC12436687/
24. Rasmussen L, Lawaetz M, Serup J, Bjoern L, Vennits B, Blemings A, et al. Randomized clinical trial comparing endovenous laser ablation, radiofrequency ablation, foam sclerotherapy, and surgical stripping for great saphenous varicose veins with 3-year follow-up. J Vasc Surg Venous Lymphat Disord [Internet]. 2013 [cited 2025 Dec 5];1(4):349–56. Available from: https://pubmed.ncbi.nlm.nih.gov/26992754/
25. Brittenden J, Cooper D, Dimitrova M, Scotland G, Cotton SC, Elders A, et al. Five-Year Outcomes of a Randomized Trial of Treatments for Varicose Veins. New England Journal of Medicine [Internet]. 2019 Sep 5 [cited 2025 Dec 5];381(10):912–22. Available from: https://www.nejm.org/doi/pdf/10.1056/NEJMoa1805186
26. Turkish Journal of Thoracic and Cardiovascular Surgery [Internet]. [cited 2025 Dec 5]. Available from: https://tjtcvs.com/
27. Hartmann K, Gholam P, Dietrich C, Fink C. Efficacy and safety of endovenous laser ablation with the 1470 nm diode laser using a novel optical probe. Int J Med Sci. 2022;19(4).
28. Hamann SAS, Timmer-de Mik L, Fritschy WM, Kuiters GRR, Nijsten TEC, van den Bos RR. Randomized Clinical Trial of Endovenous Laser Ablation Versus Direct and Indirect Radiofrequency Ablation for the Treatment of Great Saphenous Varicose Veins. J Vasc Surg Venous Lymphat Disord [Internet]. 2019 Sep 1 [cited 2025 Dec 5];7(5):763–4. Available from: https://www.jvsvenous.org/action/showFullText?pii=S2213333X19303439
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| Issue | Vol 64 No 3 (2026) | |
| Section | Original Articles | |
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| Endo-Venous Radiofrequency Ablation Varicose Veins Quality of Life (QoL) | ||
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How to Cite
1.
Al-Mashhadani AA. -One-Year Clinical and Patient-Reported Outcomes After Endovenous Radiofrequency Ablation for Varicose Veins: A Prospective Cohort Study. Acta Med Iran. 2026;64(3):160-169.
