The Role of Endovenous Thermal Ablation in the Treatment of Varicose Veins
Author(s)
Shepherd, Amanda Claire
Type
Thesis
Abstract
Varicose veins are a common problem affecting approximately 30% of the Western population. The
majority of patients present to secondary care complaining of a number of commonly experienced
symptoms, however, some present with severe complications of venous disease including venous
ulceration. For hundreds of years varicose veins have been treated with compression and surgery. In
the last decade, technological advances have lead to the introduction of minimally invasive therapies
for varicose veins, with the aim of providing rapid treatment with minimum discomfort to the
patient at acceptable cost to the healthcare provider.
This study examined the current use of endovenous ablation procedures in the United Kingdom
amongst consultant vascular surgeons using an online questionnaire and also explored the patient’s
views regarding treatment of varicose veins and potential therapeutic options. Prior to conducting a
randomised clinical trial comparing early outcomes following laser and radiofrequency ablation in
patients with primary varicose veins, an observational pilot study was carried out in the department.
In parallel, the use of disease specific quality of life tools were compared to clinical, anatomical and
haemodynamic outcome measures in this cohort of patients.
The findings of the study have shown that although endovenous ablation procedures appear to be
increasing in popularity, traditional surgery remains the most frequently performed procedure.
Overall, patients overall have little knowledge of potential treatment options and the majority would
be in favour of a single treatment under a local anaesthetic. However, most would be strongly
influenced by the advice and opinion of the surgeon to whom they were referred.
Results from the pilot study and a randomised clinical trial showed that radiofrequency ablation is
significantly less painful than laser ablation for up to 10 days post procedure. Clinical improvements
and gains in quality of life were significantly improved at 6 weeks and 6 months post intervention
compared with baseline scores and were comparable between the groups. No significant difference
was observed in anatomical outcomes between the two treatments.
Although radiofrequency may be less painful than laser ablation, both endovenous thermal ablation
treatments result in significant improvements in quality of life and are likely to become increasingly
popular in the future.
majority of patients present to secondary care complaining of a number of commonly experienced
symptoms, however, some present with severe complications of venous disease including venous
ulceration. For hundreds of years varicose veins have been treated with compression and surgery. In
the last decade, technological advances have lead to the introduction of minimally invasive therapies
for varicose veins, with the aim of providing rapid treatment with minimum discomfort to the
patient at acceptable cost to the healthcare provider.
This study examined the current use of endovenous ablation procedures in the United Kingdom
amongst consultant vascular surgeons using an online questionnaire and also explored the patient’s
views regarding treatment of varicose veins and potential therapeutic options. Prior to conducting a
randomised clinical trial comparing early outcomes following laser and radiofrequency ablation in
patients with primary varicose veins, an observational pilot study was carried out in the department.
In parallel, the use of disease specific quality of life tools were compared to clinical, anatomical and
haemodynamic outcome measures in this cohort of patients.
The findings of the study have shown that although endovenous ablation procedures appear to be
increasing in popularity, traditional surgery remains the most frequently performed procedure.
Overall, patients overall have little knowledge of potential treatment options and the majority would
be in favour of a single treatment under a local anaesthetic. However, most would be strongly
influenced by the advice and opinion of the surgeon to whom they were referred.
Results from the pilot study and a randomised clinical trial showed that radiofrequency ablation is
significantly less painful than laser ablation for up to 10 days post procedure. Clinical improvements
and gains in quality of life were significantly improved at 6 weeks and 6 months post intervention
compared with baseline scores and were comparable between the groups. No significant difference
was observed in anatomical outcomes between the two treatments.
Although radiofrequency may be less painful than laser ablation, both endovenous thermal ablation
treatments result in significant improvements in quality of life and are likely to become increasingly
popular in the future.
Date Issued
2010-08
Date Awarded
2011-11
Copyright Statement
Attribution NoDerivatives 4.0 International Licence (CC BY-ND)
Advisor
Davies, Alun
Gohel, Manjit
Sponsor
Mason Medical Research group and the Royal Society of Medicine
Creator
Shepherd, Amanda Claire
Publisher Department
Surgery and Cancer
Publisher Institution
Imperial College London
Qualification Level
Doctoral
Qualification Name
Doctor of Medicine (Research) MD (Res)