Risk Factors for Recanalization of Truncal Veins Following Endoluminal Ablation.

BACKGROUND: Recanalization of target veins following treatment of superficial venous incompetence has clinical implications and may be dependent on the type of intervention. The aim of this study was to evaluate patient and procedural factors associated with truncal vein recanalization in a large study cohort using the Vascular Quality Initiative (VQI) Varicose Vein Registry.

METHODS: We performed a retrospective review using the VQI Varicose Vein Registry from 2014 to 2018. We evaluated all procedures performed for truncal venous insufficiency. Demographic data and information about treatment modality were collected. Patients were separated into recanalization and non-recanalization groups based on the status of the treated vein at follow up ultrasonography. The vein was only considered recanalized if the VQI noted complete recanalization of the target vein. Univariate and multivariate comparisons were performed as appropriate.

RESULTS: A total of 10,604 procedures were performed in 7403 patients. The average age was 55.9 years and 70.3% of the patients were female. Patients with recanalization were more likely to have a history of phlebitis (p<0.001) and had a higher mean BMI (30.5 versus 32.7, kg/m2 = 0.006) compared with those without recanalization. There was no difference in the use of compression therapy, anticoagulation, deep venous reflux, number of pregnancies, prior DVT, VCSS and CEAP between patients with and without recanalization. The number of truncal veins treated per procedure was higher in the recanalization group compared with the non-recanalization group (2.36 v 1.88, P=0.001). Following multivariate logistic regression, laser ablation was associated with higher rate of recanalization compared to radiofrequency ablation (P=0.017).

CONCLUSION: This study is the first to use VQI based data to describe risk factors for recanalization following treatment of truncal venous reflux. The use of laser ablation for truncal veins is associated with a higher risk for recanalization compared with radiofrequency ablation. Obesity, prior phlebitis, and number of veins treated, were independently associated with increased rate of recanalization.