Does the Residual Venous Reflux After the Treatment for Saphenous Varicose Vein Affect Patient’s QOL?

Introduction, Objectives, and/or Purpose:

Purpose: The persistent venous reflux is often found after treatment for varicose veins, and it may lead to recurrent varicose veins. However, it is unclear how residual venous reflux will affect patient’s QOL. The purpose of this study is to identify the influence of residual venous reflux for QOL.

Methods:

Methods: We had 140 patients who accepted the more than 1 year follow up with venous examinations after endovenous ablation (1470nm Diode laser 2 rings radial fiber or VenaSeal Closure) for primary saphenous varicose veins from July 1st, 2020 to Dec 31st 2021, for this single center, prospective, cohort study. In these patients, 57 patients didn’t visited the hospital at all designated periods were removed in this study due to strict analysis, and 93 patients,116 legs(CEAP C, C2 42%, C3 36%, ≧C4 22%) who could be followed up more than 1 year participated in this study. Concomitant phlebectomy was done for 44 legs and staged sclerotherapy for 20 legs after post-operative 3 months.
Clinical outcomes were prospectively assessed using physical examinations, Duplex ultrasound at pre, post 1 month and 1 year, Air plethysmography (APG) pre and post 3 months, and QOL using VCSS and Aberdeen QOL Questionnaire score at pre, post 1 month and 1 year.
The definition of residual venous reflux is 2 ml/min venous filling index (VFI) using APG with detection of venous reflux by duplex ultrasound. 44 legs categorized in residual venous reflux group (RVG), 60 categorized in non-residual venous reflux group (NRVG). The change of VCSS and AVVQ from pre to post 1 year was evaluated between RVG and NRVG.
Back ground data comparison, VCSS and AVVQ scores and frequency of residual varicose vein were analyzed with student t test, Man Whitney U test, Chi-squared test, one-way analysis of variance and Tukey-Kramer test depending on the statistical situation.

Results:

Results: Preoperative VFI in RVG was significantly higher than in NRVG. Staged sclerotherapy was done for 31.8% of RVG, 8.3% of NRVG. Persistent or new varicose veins at post-operative 1 year were found in 11.4% of RVG, 3.3% of NRVG. (NS)
VCSS and AVVQ improved significantly over time in both groups. Although preoperative VCSS in RVG was higher than in NRVG, VCSS and AVVQ at post 1 year in RVG were higher than in NRVG. (Table 1 and 2)

Conclusion(s):

Conclusions: Residual venous reflux after treatment for varicose veins may affect patient QOL and clinical results at post-operative 1 year.