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- W2912071392 abstract "Radiofrequency ablation (RFA) has become the primary modality of treating perforator vein insufficiency. Previous studies have shown a closure rate of 60% to 80% in incompetent perforator veins (IPVs) with RFA. The purpose of the study was to determine utility of redo RFA for symptomatic recanalized perforators and to predict factors associated with recanalization. A retrospective analysis of 642 procedures in 256 patients with venous insufficiency due to IPVs from 2009 to 2015 was conducted. A redo ablation was done in 52 IPVs (28 patients) including 13 women, with mean age of 65 years (standard deviation [SD], ±15 years). The patients had presenting symptoms of Clinical, Etiology, Anatomy, and Pathophysiology (CEAP) class C1 (0), C2 (0), C3 (5), C4a (13), C4b (9), C5 (0), and C6 (25). The 52 IPVs were distributed in calf (40) and ankle (12). The mean maximum diameter of targeted veins was 4.6 mm (SD, ±1.1 mm). Postoperative duplex ultrasound scans were performed after 3 to 7 days. Successful obliteration was defined as lack of color flow. Follow-ups were conducted every 3 months in the first year and every 6 months thereafter. The initial success rate was 64.9%. Repeated procedures done in the 52 recanalized IPVs had an early closure rate of 67.3%. At follow-up after a mean duration of 24 months (SD, ±16.8 months), the closure rate was 65.38%. No complications (burns, skin necrosis, wound infection, arterial or nerve injury) were observed. The rate of deep venous thrombosis was <1% and involved only focal segments of the tibial veins. No clinical correlation was observed between successful obliteration in the redo procedure and age (P = .54), gender (P = .14), presenting symptoms of CEAP class (P = .82), laterality (P = .84), or location of the vein (P = .54). When data were compared to predict factors, IPVs located in mid and distal calf areas tended to recanalize more compared with the ankle (P = .04). Temperature of the RFA probe showed linear association, with patients treated at 85°C having higher probability of recanalization compared with 90°C and 95°C (P = .01). Otherwise, age (P = .90), gender (P = .66), presenting CEAP symptoms (P = .36), laterality (P = .38), and vein diameter (P = .36) were not predictive for recanalization. The rates of successful closure for IPVs on initial and redo procedures are comparable. The data validate utility of redo perforator vein closures and indicate that temperature of the RFA probe and location of IPVs may be predictive of a successful outcome or recanalization." @default.
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- W2912071392 date "2017-10-01" @default.
- W2912071392 modified "2023-09-28" @default.
- W2912071392 title "Success Rate and Predictive Factors for Redo Radiofrequency Ablation of Perforator Veins" @default.
- W2912071392 doi "https://doi.org/10.1016/j.jvs.2017.07.090" @default.
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