WANG Jiaxu, ZHANG Wei, HAN Tian, et al. Analysis of the efficacy and prognosis influence factors of ultrasound-guided radiofrequency ablation for lower extremity venous insufficiency. [J]. Journal of Clinical Ultrasound in Medicine 23(5):342-346(2021)
WANG Jiaxu, ZHANG Wei, HAN Tian, et al. Analysis of the efficacy and prognosis influence factors of ultrasound-guided radiofrequency ablation for lower extremity venous insufficiency. [J]. Journal of Clinical Ultrasound in Medicine 23(5):342-346(2021) DOI: 10.16245/j.cnki.issn1008-6978.2021.05.007.
Analysis of the efficacy and prognosis influence factors of ultrasound-guided radiofrequency ablation for lower extremity venous insufficiency
ObjectiveTo evaluate the therapeutic effect of combined radiofrequency ablation(RFA)/stripping surgery for the treatment of the great saphenous vein
incompetent perforator veins and foam sclerosis for shallow veins.And to analyze the factors affecting the closure rate of the great saphenous vein trunk after radiofrequency ablation.Methods hundred and two patients with varicose veins of lower extremities(168 limbs)were selected. All patients were treated by combination therapy of ultrasound guided radiofrequency ablation for the great saphenous vein
stripping surgery for incompetent perforator veins and foam sclerosis for shallow veins.The patients were followed up for 6 months after operation.The Logistic regression analysis was used to analyze the factors affecting the radiofrequency closure rate.The receiver operating characteristic(ROC)curve was drawn to analyze the cut-off value and diagnostic efficacy of related factors.ResultsA total of 23 limbs still needed surgical intervention after 6 months follow up.Among them
12 limbs had recanalization in the radiofrequency-target vein segment
2 limbs had recurrent collateral varices
4 limbs had recurrent small saphenous varices
and 5 limbs had dysfunctional communicating veins.No serious complication was found after the operation
and 4 limbs had subcutaneous soft tissue edema.The successful rate of combined therapy was 87%. Logistic regression analysis showed that the diameter of great saphenous vein before operation was an independent risk factor of recanalization after ultrasound-guided radiofrequency ablation(P<0.05)
while the factors including age
gender
CEAP grading
blood pressure and blood glucose were not associated with closure rate.ROC curve analysis showed that the cut-off value of preoperative diameter of the great saphenous vein was 8.5 mm
and the area under ROC curve about the affecting efficacy of ultrasound guided radiofrequency ablation was 0.764(95% confidence interval:0.623~0.905)
sensitivity was 75.0% and specificity was 80.8%.ConclusionThe combined therapy effect of ultrasound guided radiofrequency ablation for the great saphenous vein
stripping surgery for incompetent perforator veins and foam sclerosis for shallow veins is effective.The preoperative diameter of the great saphenous vein is an important risk factor of recanalization for the vein after ultrasound-guided radiofrequency ablation.
关键词
超声引导下肢静脉曲张交通支静脉射频消融大隐静脉直径术前
Keywords
Ultrasound guidanceVaricose veinsPerforator veinsRadiofrequency ablationDiameter of greatsaphenous veinpreoperative
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Related Author
张巍
韩天
韩林霖
杨秀华
汪佳旭
曹小丽
陈黄卓楠
王国运
Related Institution
The First Affiliated Hospital of Harbin Medical University
青岛大学附属烟台航璜顶医院超声科
山东省烟台市毓璜顶医院
滨州医学院医学影像学院
Department of Ultrasound, Yantai Yuhuangding Hospital of Qingdao University