射频消融术治疗下肢静脉曲张的研究现状

doi:10.3969/j.issn.1006-5725.2025.17.022

Abstract

Abstract:

Varicose veins in the lower extremities （VVLEs） are a common vascular disease caused by Chronic Venous Insufficiency （CVI）. Traditional High Ligation and Stripping （HLS） of The Great Saphenous Vein has been largely replaced by minimally invasive techniques due to its greater surgical trauma and slower recovery. Among these techniques， radiofrequency ablation （RFA） has emerged as a preferred treatment option due to its high efficacy and safety. RFA utilizes thermal energy to occlude diseased veins， demonstrating significantly superior short- and long-term closure rates compared to traditional HLS. Additionally， RFA is associated with reduced postoperative pain and a lower incidence of complications. This review comprehensively summarizes the current applications， clinical efficacy， safety profile， and future research directions of RFA in treating VVLEs， aiming to provide a valuable reference for the clinical implementation of this technique.

Key words: varicose veins in lower extremities, radiofrequency ablation, efficacy evaluation, postoperative complications

CLC Number:

R654.4

Hecheng SUN,Haiyang WANG. Radiofrequency ablation for lower extremity varicose veins： A comprehensive review[J]. The Journal of Practical Medicine, 2025, 41(17): 2761-2766.

References 51

[1]	ROCHON P J， REGHUNATHAN A， KAPOOR B S， et al. ACR Appropriateness Criteria^® Lower Extremity Chronic Venous Disease ［J］. J Am Coll Radiol， 2023， 20（11s）： S481-s500. doi:10.1016/j.jacr.2023.08.011 doi: 10.1016/j.jacr.2023.08.011
[2]	何楠，张腾飞，梁紫轲，等. 下肢静脉曲张微创治疗现状及评价［J］. 中国实用外科杂志， 2023， 43（12）： 1364-1368.
[3]	KRAUS A L， RABE E， KOWALL B， et al. Differences in risk profile associated with varicose veins and chronic venous insufficiency - results from the Bonn Vein Study 1 ［J］. Vasa， 2024， 53（2）： 145-154. doi:10.1024/0301-1526/a001115 doi: 10.1024/0301-1526/a001115
[4]	RUSINOVICH Y， RUSINOVICH V. Earth's gravity field and prevalence of varicose veins and chronic venous disease： Systematic review ［J］. Phlebology， 2022， 37（7）： 486-495. doi:10.1177/02683555221090054 doi: 10.1177/02683555221090054
[5]	NADASY G L， PATAI B B， MOLNAR A A， et al. Vicious Circle With Venous Hypertension， Irregular Flow， Pathological Venous Wall Remodeling， and Valve Destruction in Chronic Venous Disease： A Review ［J］. Angiology， 2024， 33197241256680. doi:10.1177/00033197241256680 doi: 10.1177/00033197241256680
[6]	JIA W， LIU J， CHENG Z. Clinical Efficacy of Endovenous Radiofrequency Ablation （RFA） for Superficial Varicose Veins of the Lower Extremities ［J］. Dis Markers， 2022， 2022：1673588. doi:10.1155/2022/1673588 doi: 10.1155/2022/1673588
[7]	李丹，蒋贻洲，黄建忠. 下肢静脉曲张微创治疗的技术选择［J］.血管与腔内血管外科杂志，2022，8（1）：78-86.
[8]	王云鹏，姚野，张博，等. 射频消融术治疗下肢静脉曲张［J］. 内蒙古医科大学学报， 2019， 41（6）： 670-672.
[9]	张明. 超声引导下射频消融治疗下肢静脉曲张的疗效观察［J］. 微创医学，2022，17（1）：67-70.
[10]	李伟，李威，满文玲，等. 射频消融术在下肢静脉曲张中的运用价值［J］. 中华介入放射学电子杂志， 2021， 9（1）： 7.
[11]	孙虎，黄小进、徐益鸣. 射频消融联合硬化剂治疗下肢静脉曲张的疗效分析［J］. 黑龙江医药， 2020， 33（5）： 3.
[12]	吴水平. DSA引导下射频消融联合聚多卡醇局部注射治疗下肢静脉曲张的疗效观察［J］. 现代实用医学，2022，34（2）：198-200.
[13]	王仲超，赵晓冲，崔金鸽，等. 腔内射频消融术联合泡沫硬化剂注射治疗下肢静脉曲张的效果观察［J］. 临床医学工程，2021，28（11）：1457-1458.
[14]	刘永昌，孟小虎，解旭品，等. 腔内射频消融术与高位结扎抽剥术治疗大隐静脉曲张疗效对比分析［J］. 浙江中西医结合杂志，2022，32（10）：934-936.
[15]	WILLENBERG T， BOSSART S， SCHUBERT M， et al. Pain after 1940 nm Laser for Unilateral Incompetence of the Great Saphenous Vein ［J］. J Clin Med， 2024， 13（13）： 3839. doi:10.3390/jcm13133839 doi: 10.3390/jcm13133839
[16]	BACCELLIERI D， ARDITA V， GALATI N， et al. Early outcomes of the Third-generation of ClosureFast radiofrequency ablation for great saphenous vein reflux ［J］. Vasa， 2025， 54（4）：280-286. doi:10.1024/0301-1526/a001195 doi: 10.1024/0301-1526/a001195
[17]	GIFFORD S M， KALRA M， GLOVICZKI P， et al. Reflux in the below-knee great saphenous vein can be safely treated with endovenous ablation ［J］. J Vasc Surg Venous Lymphat Disord， 2014， 2（4）： 397-402. doi:10.1016/j.jvsv.2014.04.004 doi: 10.1016/j.jvsv.2014.04.004
[18]	贺海朋，蔡双红，招扬，等. 超声引导下不同穿刺部位射频消融治疗大隐静脉曲张的近期疗效分析［J］. 中山大学学报（医学科学版）， 2020， 41（2）： 288-293.
[19]	苑超，高荣键，孙伟东，等. 超声引导下腔内射频消融联合点式剥脱治疗下肢静脉曲张的临床效果观察［J］. 现代生物医学进展， 2020， 20（7）： 1272-1276.
[20]	GAO R D， QIAN S Y， WANG H H， et al. Strategies and challenges in treatment of varicose veins and venous insufficiency ［J］. World J Clin Cases， 2022， 10（18）： 5946-5956. doi:10.12998/wjcc.v10.i18.5946 doi: 10.12998/wjcc.v10.i18.5946
[21]	NYAMEKYE I K. European Society for Vascular Surgery （ESVS） 2022 clinical practice guidelines on the management of chronic venous disease of the lower limbs ［J］. J Med Vasc， 2022， 47（2）： 53-55. doi:10.1016/j.jdmv.2022.04.003 doi: 10.1016/j.jdmv.2022.04.003
[22]	江志虹，阎军，王世材，等. 蠕动泵推注肿胀液在下肢静脉曲张病人行大隐静脉射频消融术中的应用［J］. 护理研究， 2023， 37（17）： 3167-3170.
[23]	牟彬，赵罡，孙闯，等. 射频消融治疗大隐静脉曲张的近期有效性及安全性［J］. 中国介入影像与治疗学， 2020， 17（2）： 84-88.
[24]	WHITELEY M S， SHIANGOLI I， DOS SANTOS S J， et al. Fifteen Year Results of Radiofrequency Ablation， Using VNUS Closure， for the Abolition of Truncal Venous Reflux in Patients with Varicose Veins ［J］. Eur J Vasc Endovasc Surg， 2017， 54（3）： 357-362. doi:10.1016/j.ejvs.2017.06.001 doi: 10.1016/j.ejvs.2017.06.001
[25]	CAMPBELL W B， VIJAY KUMAR A， COLLIN T W， et al. The outcome of varicose vein surgery at 10 years： Clinical findings， symptoms and patient satisfaction ［J］. Ann R Coll Surg Engl， 2003， 85（1）： 52-57. doi:10.1308/003588403321001462 doi: 10.1308/003588403321001462
[26]	PANNONE A， DI GIROLAMO A， ORRICO M， et al. Outcome Measures of In-Office Endovenous Radiofrequency Treatment of Varicose Vein Feasibility ［J］. Diagnostics （Basel）， 2023， 13（2）： 327. doi:10.3390/diagnostics13020327 doi: 10.3390/diagnostics13020327
[27]	JIANG W， LIANG Y， LONG Z， et al. Endovenous radiofrequency ablation vs laser ablation in patients with lower extremity varicose veins： A meta-analysis ［J］. J Vasc Surg Venous Lymphat Disord， 2024， 12（5）： 101842. doi:10.1016/j.jvsv.2024.101842 doi: 10.1016/j.jvsv.2024.101842
[28]	NELZéN O， SKOOG J， BERNFORT L， et al. Editor's Choice - Short Term Cost Effectiveness of Radiofrequency Ablation and High Ligation and Stripping for Great Saphenous Vein Incompetence ［J］. Eur J Vasc Endovasc Surg， 2024， 67（5）： 811-817. doi:10.1016/j.ejvs.2024.01.085 doi: 10.1016/j.ejvs.2024.01.085
[29]	王硕，杨耀国，唐小斌，等. 射频消融术与大隐静脉高位结扎剥脱术治疗下肢静脉曲张的疗效比较［J］. 中国普通外科杂志， 2023， 32（6）： 899-908.
[30]	ELZEFZAF N， ELFEKY M A， ELSHATLAWY K M， et al. Evaluation of Endovenous Laser Ablation in the Management of Varicose Veins ［J］. Cureus， 2023， 15（9）： e45096.
[31]	SETIA A， DIKIC S， DEMHASAJ S， et al. Prospects of Endovenous Laser Ablation （EVLA） Standardization-Mid-Term Results of a Four-Zone Dosimetry Guiding Tool for 1940 nm Laser ［J］. J Clin Med， 2023， 12（13）： 4313. doi:10.3390/jcm12134313 doi: 10.3390/jcm12134313
[32]	陈智勇，王龙，欧阳欢，等. 腔内微波消融与射频消融治疗大隐静脉曲张的对比研究［J］. 中华普通外科杂志， 2023， 38（10）： 765-771.
[33]	ZHAO N， GUO H， ZHANG Y， et al. Comparison of endovenous microwave ablation versus radiofrequency ablation for lower limb varicose veins ［J］. J Vasc Surg Venous Lymphat Disord， 2024， 12（1）： 101662. doi:10.1016/j.jvsv.2023.03.022 doi: 10.1016/j.jvsv.2023.03.022
[34]	TALUTIS S D， CHIN A L， LAWRENCE P F， et al. Comparison of outcomes following polidocanol microfoam and radiofrequency ablation of incompetent thigh great and accessory saphenous veins ［J］. J Vasc Surg Venous Lymphat Disord， 2023， 11（5）： 916-920. doi:10.1016/j.jvsv.2023.03.015 doi: 10.1016/j.jvsv.2023.03.015
[35]	BELRAMMAN A， BOOTUN R， TANG T Y， et al. Pain Outcomes Following Mechanochemical Ablation vs Cyanoacrylate Adhesive for the Treatment of Primary Truncal Saphenous Vein Incompetence： The MOCCA Randomized Clinical Trial ［J］. JAMA Surg， 2022， 157（5）： 395-404. doi:10.1001/jamasurg.2022.0298 doi: 10.1001/jamasurg.2022.0298
[36]	MING LIM A J， MOHAMED A， LEUNG C， et al. Five Year Follow Up of a Randomised Clinical Trial of Endovenous Laser Ablation versus Mechanochemical Ablation for Superficial Venous Incompetence （LAMA trial）［J］. Eur J Vasc Endovasc Surg， 2025. doi:10.1016/j.ejvs.2025.04.038 doi: 10.1016/j.ejvs.2025.04.038
[37]	RAZAQUE A， SHAZLEE M K， QAMAR S， et al. Early Results of Mechanochemical Ablation by Flebogrif and Radiofrequency Ablation in Treating Primary Varicose Veins of Lower Limb ［J］. Cureus， 2023， 15（9）： e45874.
[38]	GARCíA-CARPINTERO E， CARMONA M， CHALCO-ORREGO J P， et al. Systematic review and meta-analysis of endovenous cyanoacrylate adhesive ablation for incompetent saphenous veins ［J］. J Vasc Surg Venous Lymphat Disord， 2020， 8（2）： 287-296. doi:10.1016/j.jvsv.2019.09.010 doi: 10.1016/j.jvsv.2019.09.010
[39]	GUO J， ZHANG F， GUO J， et al. A systematic review and meta-analysis comparing the efficacy of cyanoacrylate ablation over endovenous thermal ablation for treating incompetent saphenous veins ［J］. Phlebology， 2021， 36（8）： 597-608. doi:10.1177/02683555211008762 doi: 10.1177/02683555211008762
[40]	GULEKEN Z， KANBER E M， SARIBAL D， et al. Applying spectrochemical analyses on venous disease patients treated by N-Butyl Cyanoacrylate Ablation Surgery ［J］. Technol Health Care， 2022， 30（5）： 1091-1106. doi:10.3233/thc-213642 doi: 10.3233/thc-213642
[41]	ER Z C， IKBALI AFSAR F， ATILGAN K， et al. Comparison of endovenous laser ablation and cyanoacrylate embolization in the non-invasive treatment of superficial venous insufficiency in terms of patient satisfaction ［J］. Phlebology， 2023， 38（7）： 436-444. doi:10.1177/02683555231182020 doi: 10.1177/02683555231182020
[42]	张作林，郭曙光. CHIVA：基于血流动力学原理治疗下肢静脉曲张的临床应用［J］. 西南国防医药， 2021， 31（4）： 3.
[43]	BELLMUNT-MONTOYA S， ESCRIBANO J M， PANTOJA BUSTILLOS P E， et al. CHIVA method for the treatment of chronic venous insufficiency ［J］. Cochrane Database Syst Rev， 2021， 9（9）： Cd009648. doi:10.1002/14651858.cd009648.pub4 doi: 10.1002/14651858.cd009648.pub4
[44]	GLOVICZKI P， LAWRENCE P F， WASAN S M， et al. The 2023 Society for Vascular Surgery， American Venous Forum， and American Vein and Lymphatic Society clinical practice guidelines for the management of varicose veins of the lower extremities. Part II： Endorsed by the Society of Interventional Radiology and the Society for Vascular Medicine ［J］. J Vasc Surg Venous Lymphat Disord， 2024， 12（1）： 101670. doi:10.1016/j.jvsv.2023.08.011 doi: 10.1016/j.jvsv.2023.08.011
[45]	LACQUEMANNE J， BAMDÉ C C， LAREYRE F， et al. Steam Vein Sclerosis for Nonsaphenous varicose veins ［J］. Ann Vasc Surg， 2025， 111：336-340. doi:10.1016/j.avsg.2024.10.016 doi: 10.1016/j.avsg.2024.10.016
[46]	ANDERCOU O， STANCU B， COMAN H F， et al. Radiofrequency Thermal Ablation for the Treatment of Chronic Insufficiency of the Saphenous Vein-A Comparative Retrospective Study ［J］. Int J Environ Res Public Health， 2023， 20（4）： 3308. doi:10.3390/ijerph20043308 doi: 10.3390/ijerph20043308
[47]	BISSACCO D， STEGHER S， CALLIARI F， et al. Relationship between great saphenous vein recanalization， venous symptoms reappearance， and varicose veins recurrence rates after endovenous radiofrequency ablation ［J］. Phlebology， 2022， 37（9）： 686-688. doi:10.1177/02683555221114537 doi: 10.1177/02683555221114537
[48]	FAYYAZ F， VAGHANI V， EKHATOR C， et al. Advancements in Varicose Vein Treatment： Anatomy， Pathophysiology， Minimally Invasive Techniques， Sclerotherapy， Patient Satisfaction， and Future Directions ［J］. Cureus， 2024， 16（1）： e51990.
[49]	ZHAI Y， LU Y M， LU W， et al. Radiofrequency ablation of the great saphenous vein in the treatment of varicose veins of the lower extremities ［J］. Ann Ital Chir， 2022， 93：235-240.
[50]	JUHANI A A， ABDULLAH A， ALYASEEN E M， et al. Interventions for great saphenous vein insufficiency： A systematic review and network meta-analysis ［J］. Vascular， 2024， 170853812412 73098. doi:10.1177/17085381241273098 doi: 10.1177/17085381241273098
[51]	BLEBEA J， FUKAYA E， MOORE K S， et al. Mechanochemical chemically assisted ablation of varicose veins for venous insufficiency： American vein and lymphatic society position statement ［J］. Phlebology， 2025， 40（2）： 104-109. doi:10.1177/02683555241276554 doi: 10.1177/02683555241276554

Radiofrequency ablation for lower extremity varicose veins： A comprehensive review

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