Race/Ethnicity and Outcomes of Venous Ablation Procedures

Endovenous ablation has become the most common procedure performed for treating patients with chronic venous insufficiency. However, there is no data looking at its effectiveness and safety in patients of different race/ethnicity. In this study, we aim to explore the endovenous heat-induced thrombosis (EHIT) and recanalization rates in patients of different race/ethnicity.

Methods:

We performed a retrospective analysis of thermal ablation procedures from 2012 to 2022 completed at our single outpatient institution and looked at endothermal heat-induced thrombosis (EHIT) and recanalization rates. Of these 13335 procedures, 8187 were radiofrequency ablations (RFA) and 5148 were endovenous laser ablations (EVLA).  8946 of these procedures were performed on female patients (67.1%). Duplex ultrasound scans were conducted in patients 3 to 7 days after their procedure, then 3 to 6 months after for the first year, and every 6 to 12 months thereafter. Recanalization and EHIT were defined as reflux or thrombus (using AVF EHIT guidelines classification) as seen on follow-up duplex ultrasound of the target vessel, respectively.

Results:

In Asian patients, the EHIT and recanalization rates were 2.6% and 3.4% respectively. The EHIT and recanalization rates in Black patients were 3.0% and 3.4% respectively. In Hispanic patients, 1.4% of patients developed EHIT and 2.4% of patients experienced recanalization. In Caucasian patients, 2.0% of patients experienced recanalization and 1.7% had EHIT. The procedural success rate in the different patient groups, defined as ablations in which recanalization or EHIT was not observed, were: 96.1% Asian, 95.2% Black, 96.1% Hispanic, 96.2% Caucasian patients. There was no significant difference in EHIT and recanalization rates among patients of different race/ethnicity. Of the patients that experienced recanalization, we did not find a difference in EHIT when stratified by race/ethnicity as compared to those that did not recanalize.

Conclusions:

This data suggests that there is no significant difference in EHIT and recanalization rates among patients of different race/ethnicity. RFA and EVLA are technically safe procedures for treating patients with chronic venous insufficiency irrespective of the race or ethnicity examined.