AB069. SOH25_AB_289. Beyond the scalpel: evaluating endovenous ablation techniques for varicose veins
Vascular Session

AB069. SOH25_AB_289. Beyond the scalpel: evaluating endovenous ablation techniques for varicose veins

En Qing Lim1, Aongus Twomey2

1Department of General Surgery, Cork University Hospital, Cork, Ireland; 2Department of Surgery, Mercy University Hospital, Cork, Ireland

Background: Varicose veins affect 17% of females and 15% of males globally, significantly impairing quality of life. Endovenous ablation techniques, including thermal [endovascular laser ablation (EVLA), radiofrequency ablation (RFA)] and non-thermal [mechanochemical ablation (MOCA), cyanoacrylate], are minimally invasive alternatives to traditional surgery. This study aimed to evaluate the efficacy, safety, and patient-reported outcomes of these interventions

Methods: A systematic search identified 35 studies with more than 6,500 patients. Primary outcomes included occlusion and recurrence rates. Secondary outcomes included patient-reported improvements using the Aberdeen Varicose Vein Questionnaire (AVVQ) and Venous Clinical Severity Score (VCSS) and adverse events. The analysis followed the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines with a random-effects model used for the data synthesis.

Results: Thermal methods (EVLA and RFA) achieved high occlusion rates of 94.9% and 94.4%, respectively, comparable to surgical stripping at 92.0%. Slightly lower rates were observed for the non-thermal methods (MOCA, cyanoacrylate) at 88.7%, but these reduced postprocedural pain. Average recurrence rates were similar between all methods at 6.2%. Improvements in AVVQ scores by 7.8 points and VCSS scores by 3.5 points reflect a quality-of-life gain. Adverse events such as superficial thrombophlebitis and skin burns were more common following thermal methods (6.8%) than non-thermal approaches (2.5%).

Conclusions: Endovenous ablation techniques are valid and safe alternatives to surgery, showing high success rates with significant improvements in quality of life. Non-thermal procedures offer less complications and less post-operative pain, which makes them very attractive options for patients. Long-term studies are warranted to confirm the durability of these new techniques.

Keywords: Varicose veins; endovenous ablation; radiofrequency ablation (RFA); endovenous laser ablation; mechanochemical ablation

Acknowledgments

None.

Footnote

Funding: None.

Conflicts of Interest: The authors have no conflicts of interest to declare.

Ethical Statement: The authors are accountable for all aspects of the work in ensuring that questions related to the accuracy or integrity of any part of the work are appropriately investigated and resolved.

Open Access Statement: This is an Open Access article distributed in accordance with the Creative Commons Attribution-NonCommercial-NoDerivs 4.0 International License (CC BY-NC-ND 4.0), which permits the non-commercial replication and distribution of the article with the strict proviso that no changes or edits are made and the original work is properly cited (including links to both the formal publication through the relevant DOI and the license). See: https://creativecommons.org/licenses/by-nc-nd/4.0/.

doi: 10.21037/map-25-ab069
Cite this abstract as: Lim EQ, Twomey A. AB069. SOH25_AB_289. Beyond the scalpel: evaluating endovenous ablation techniques for varicose veins. Mesentery Peritoneum 2025;9:AB069.

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