The Impact of Endovenous Thermal Ablation on Venous Leg Ulcer Healing

The role of endovenous thermal ablation modalities, such as radiofrequency ablation (RFA) of the saphenous veins, in the treatment of active venous ulcers remains unclear. The aim of this study was to assess the impact of endovenous thermal ablation on venous leg ulcer healing. A retrospective chart review was carried out of all patients undergoing RFA at a single institution for active venous leg ulcers in the years 2015 to 2017. Baseline characteristics of the patients, healing rates, and time to healing were assessed. Thirty-seven patients were identified. The majority were male (68%), and the median age was 65 years (range, 33-95 years). All ulcers were refractory to treatment by a wound care specialist, and the median duration of wounds before RFA treatment was 6 months (range, 1-120 months). Venous leg ulcers were present on the left (54%) and right (41%) legs and bilaterally (5%). The great saphenous vein (68%), small saphenous vein (14%), and both great and small saphenous veins (19%) were treated where evidence of reflux was present. Three patients (8%) had undergone previous venous therapies on the affected limb. Complete ulcer healing occurred in 72% of patients, at a median of 2 months after the procedure (range, 0.25-8 months). RFA therapy is beneficial in successfully treating active venous ulcers in some patients. A prospective randomized controlled trial is needed to adequately assess whether this treatment modality should become a standard of care in this population of patients.