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Break in Exhibit Hall & Posters in Foyer

Break in Exhibit Hall & Posters in Foyer

Patients Undergoing Ablation of Varicose Veins Have Low Incidence of Arterial Disease

Tuesday, March 5, 2024
3:15 PM – 4:45 PM EST
Location: Foyer
Objective:

Advanced varicose veins have been previously associated with peripheral arterial disease (PAD). The aim of the study was to examine the incidence of PAD in patients undergoing ablation of varicose veins.

Methods:

All patients undergoing venous ablation in our multi-center single institution Vascular Quality Initiative (VQI) registry were included. Patients who had Ankle Brachial Indices (ABI) within two years of venous ablation were considered for this study. Abnormal ABI was defined as ≤0.9 and an ABI of < 0.5 was considered as severe disease. We collected Clinical, Etiology, Anatomy, and Pathophysiology (CEAP) classification and degree of severity of arterial disease alongside demographics and comorbidities. Univariate analysis was used to evaluate for an association between varicose veins and arterial disease. We used Fisher's exact and Wilcoxon rank sum tests to investigate the association between PAD and CEAP score.

Results:

Between 2014 and 2022, 621 patients underwent 820 ablation procedures. Of these patients, 58 had at least one ABI within two years. Eight (13.8%) patients had at least one abnormal ABI and two (3.4%) had severe arterial disease. Looking at the legs, only four patients had an abnormal ABI on the operative leg (range 0.68-0.88). In addition, four patients had an abnormal ABI (range 0.34 to 0.89) on the contralateral leg. On comparative analysis, it did not show a significant association between CEAP score and PAD (p = 0.88). When comparing patients who had an ABI to those who did not have an ABI, there was a tendency to perform more ABIs in patients with higher CEAP scores (C0-C3: 8.3%, C4: 13%, C5-C6: 17%, p = 0.051).

Conclusions:

In our patient population, only a small minority of patients with varicose veins had significant peripheral artery disease. In our health system, very few patients with PAD were offered varicose vein ablation therapy. In patients with PAD, saphenous veins should be saved and not ablated.