The prevalence of severe chronic venous insufficiency (CVI) is significant in the growing octogenarian population. While radiofrequency ablation (RFA) is a standard minimally invasive treatment, robust data on its outcomes and safety profiles specifically in patients aged 80 years and older remain scarce. This study aims to evaluate the risks and benefits of RFA in this specific, high-risk demographic.This prospective, single-arm, single-center cohort study will enroll 50 patients (initial target sample size) aged ≥80 years with CVI classified as CEAP C3 to C6 and with confirmed great or small saphenous vein reflux. All participants will undergo endovenous RFA under tumescent local anesthesia. The primary outcomes are: 1) the great/small saphenous vein occlusion rate at 6 months, assessed by duplex ultrasonography, and 2) the change in disease-specific quality of life from baseline to 6 months, measured by the Aberdeen Varicose Vein Questionnaire (AVVQ). Secondary outcomes include occlusion rates at 1 and 3 months; complication rates (e.g., deep vein thrombosis, skin burns, paresthesia) within 30 days; and changes in the Venous Clinical Severity Score (VCSS) and the 12-Item Short Form Health Survey (SF-12) at predefined intervals over 6 months.This study is designed to demonstrate a high technical success rate (occlusion rate \>95% at 6 months) and a statistically significant improvement in AVVQ and VCSS scores at 6 months post-procedure. The collected data will provide a detailed profile of complication rates, characterizing the safety of RFA in this very elderly cohort.This study will provide crucial, prospective evidence regarding the efficacy and safety of RFA for treating CVI in octogenarians. The findings are expected to guide clinical decision-making and inform treatment guidelines for this vulnerable and expanding patient population.
Age: Aged 80 years or older.
C3: Venous edema
C4a: Pigmentation or eczema
C4b: Lipodermatosclerosis or atrophie blanche
Mobility: Non-ambulatory or bedridden.
Thrombosis: Presence of acute superficial thrombophlebitis of the target vein, or deep vein thrombosis (DVT) in the target limb.
Arterial Disease: Significant peripheral arterial disease, defined as an ankle-brachial index (ABI) < 0.8 in the target limb.
Coagulopathy: Uncorrectable coagulation disorder.
The study population consists of patients aged 80 years and older who are diagnosed with symptomatic, severe chronic venous insufficiency (CVI), classified as CEAP clinical classes C3 through C6, and have confirmed great or small saphenous vein reflux.
Cohort
Prospective
Endovenous Radiofrequency Ablation
Procedure/SurgeryAll patients undergo endovenous radiofrequency ablation(RFA) under local tumescent anesthesia. Using the ClosureFast™ system (or equivalent), the target saphenous vein is accessed percutaneously under ultrasound guidance. After catheter placement and tumescent anesthesia infiltration, radiofrequency energy is delivered segmentally to ablate the vein. Post-procedure, compression bandaging is applied and Class II compression stockings are prescribed.
Great/Small Saphenous Vein Occlusion Rate at 6 Months
Aberdeen Varicose Vein Questionnaire (AVVQ)
Minimum Score: 0 Maximum Score: 100 Interpretation of Higher Scores: A higher score indicates more severe symptom distress and greater impact on quality of life caused by varicose veins in patients. For example, it reflects more obvious discomforts such as leg pain, a heavy sensation in the legs, and swelling.
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