A Retrospective Study of Outcomes in a Rural Pediatric Population Treated for Venous Insufficiency

Background: Endovascular radiofrequency ablation (RFA) and Endovascular Laser Ablation (EVLA) are minimally invasive methods to safely treat symptomatic varicose veins in pediatric patients. This research aimed to review the management of pediatric patients with venous insufficiency, evaluate the outcome, and determine the efficacy, convenience, and safety of ablation procedures in an outpatient setting.

Methods: A retrospective chart review of all patients seen at six locations from 2013 to 2024 was completed. Statistical analysis was done using QuickCalcs by GraphPad.

Results: Subjects identified were 34 adolescents with an average age at onset of symptoms of 16.7 years. Ultrasound evaluation was performed on 30 patients (88 %), and among them, 16 met the criteria for treatment. Of those, 13 patients (81 %) received the recommended intervention. RFA or EVLA was done for eight limbs, sclerotherapy for three limbs, and phlebectomy for one limb. No major complications were noted. Females were more likely to have disease in both legs than males (P = 0.04). Male patients were more likely to receive treatments regarding their diagnosis (p < 0.05). Of the 6 patients undergoing EVLA or VNUS, all 8 limbs (100 %) demonstrated total occlusion. There were no DVTs, pulmonary emboli (PEs), or any major complications noted post procedures in this population. No relationship was identified between; sex and vein size; obesity and disease severity or vein size; age and disease severity, vein size, or reflux time.

Conclusion: Out-patient ablation procedures (RFA or EVLA) proved to be a safe and effective method for the treatment of venous insufficiency in pediatric patients. Female pediatric patients with venous insufficiency symptoms should have a careful evaluation of both extremities for venous disease. Further research with larger cohorts is warranted.

Type of study: Retrospective Chart Review Study.

Evidence: Level 3.