Radiofrequency ablation of the long saphenous vein without high ligation versus high ligation and stripping for primary varicose veins: pros and cons

Abstract

Primary varicose vein disease is prevalent in our society, and although it is infrequently the cause of serious venous insufficiency, it often is associated with symptoms of local discomfort. These symptoms eventually may outweigh any cosmetic concerns of patients with this disease. Greater saphenous vein (GSV) reflux is the most important pathophysiologic component of primary venous insufficiency. To date, the surgical treatment of GSV reflux has evolved into 1 of 3 procedures: high ligation of the saphenofemoral junction, with or without perforator ligation; high ligation and stripping of the GSV; and high ligation with retrograde sclerotherapy of the GSV. High ligation and stripping of the GSV to below the knee enjoys the most durable success yet is associated with significant perioperative morbidity. A new treatment, radiofrequency ablation of the GSV without high ligation, recently has been described and promises a less invasive alternative to stripping with decreased morbidity and increased patient acceptance. The results of high ligation and stripping of the GSV will be compared with those with radiofrequency ablation of the GSV without high ligation.