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. 2022 Apr;15(4):563-569.
doi: 10.25122/jml-2021-0318.

Anterior accessory great saphenous vein as a cause of postoperative recurrence of veins after radiofrequency ablation

Yrij Svidersky  1 , Volodymyr Goshchynsky  1 , Bogdan Migenko  1 , Liudmyla Migenko  2 , Oleg Pyatnychka  1
Affiliations

Anterior accessory great saphenous vein as a cause of postoperative recurrence of veins after radiofrequency ablation

Yrij Svidersky et al. J Med Life. 2022 Apr.

Abstract

There are problems of postoperative relapse of veins after radiofrequency ablation (RFA). The study aims to analyze the causes of postoperative recurrence of veins after RFA. 928 patients with varicose veins of the lower extremities, clinical classes C2-C4 according to the CEAP classification, were treated in the ambulatory surgery centers using RFA. The causes of varicose recurrence showed that it was caused by: a) high fusion of the anterior accessory great saphenous vein (AAGSV) with great saphenous vein (GSV) directly in the saphenofemoral junction (SFJ), which was not revealed by preoperative ultrasound (1.7%); a long stump of the GSV after the RFA (7.8%); progression of varicose disease with the small saphenous vein (SSV) and formation of new reflux associated with insufficiency of the saphenopopliteal junction (SPJ) (4.7%); d) insufficiency of perforating veins of the tibioperoneal group (Sherman, Boyd), as well as Gunter (3.8%); e) neovascularization with dilation of small vessels in the area of the saphenofemoral junction (0.97%). A comparative assessment of the quality of life (QL) after different surgery methods 3 years after implementation was carried out. Thus, QL in all patients who underwent surgery significantly improved than before surgery. However, after the RFA GSV+AAGSV, the patients had better QL by all scales than those who underwent only RFA GSV. Operations performed simultaneously on GSV and AAGSV have better functionality than GSV-only RFA.

Keywords: AAGSV – anterior accessory great saphenous vein; CEAP – Clinical-Etiological-Anatomical-Pathophysiological; QoL – quality of life; RFA; RFA – radiofrequency ablation; SFJ – saphenofemoral junction; SPJ – saphenopopliteal junction; SSV – small saphenous vein; anterior accessory great saphenous vein; postoperative recurrence of veins.

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Figures

Figure 1.
Figure 1.
The number of patients by clinical features (the CEAP classification).
Figure 2.
Figure 2.
Ultrasound examination results of AAGSV insufficiency, SFJ before radiofrequency ablation of veins.
Figure 3.
Figure 3.
High fusion of the AAGSV with GSV directly in SFJ (A – SFJ, B – GVS, C – AAGSV).
See this image and copyright information in PMC

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