Tehran University of Medical Sciences Acta Medica Iranica 0044-6025 64 3 2026 05 20 160 169 Ahmed Ali Al-Mashhadani Surgery department, College of Medicine, University of Al-Mustansiriyah, Iraq. 2025 12 24 2026 01 24 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.   https://acta.tums.ac.ir/index.php/acta/article/view/11956 https://acta.tums.ac.ir/index.php/acta/article/download/11956/6035