BackgroundLipedema is a chronic and progressive disorder of subcutaneous adipose tissue that predominantly affects women and is frequently misdiagnosed as obesity, lymphedema, or venous disease. Increasing evidence indicates that lipedema represents a systemic vascular-lymphatic-inflammatory disorder rather than a cosmetic or metabolic condition. Delayed diagnosis often results in progressive fibrosis, lymphatic dysfunction, chronic pain, and functional impairment.ObjectiveThis review aims to present a structured, clinically applicable framework for the diagnosis and multimodal management of lipedema within phlebology practice, with an emphasis on stage-specific assessment and integrated therapeutic strategies.MethodsA narrative clinical review of peer-reviewed literature in phlebology, vascular medicine, lymphatic disorders, and adipose tissue pathology was conducted. Diagnostic criteria, clinical staging, and differential diagnostic features were synthesized into a practical, stage-based framework. A multilayer therapeutic approach targeting inflammation, lymphatic function, adipose tissue pathology, extracellular matrix remodeling, and post-treatment rehabilitation is proposed.ResultsAccurate diagnosis of lipedema relies primarily on clinical evaluation, including pain assessment, tissue palpation, characteristic fat distribution, and exclusion of lymphedema and simple obesity. Early-stage identification enables effective intervention focused on inflammation control and lymphatic unloading, potentially preventing irreversible fibrosis. Advanced stages require targeted adipose tissue interventions, fibrosis management, and structured rehabilitation to preserve mobility and quality of life.ConclusionLipedema should be recognized as a systemic vascular-lymphatic-inflammatory disorder within phlebology practice. Early diagnosis and implementation of a structured, stage-specific multimodal treatment framework may significantly alter disease progression and reduce the risk of long-term disability.
Chronic venous disease (CVD) is one of the most common vascular disorders, affecting millions of people worldwide. Owing to the variability of clinical symptoms and the subjective nature of their interpretation, diagnosing CVD at an early stage is complicated, making it crucial for patients to consult a specialist. It was hypothesized that an artificial intelligence (AI) model could accurately classify CVD (C0-C2 Clinical, Etiology, Anatomy, and Pathophysiology (CEAP) clinical class) from lower limb photographs. Therefore, this study aimed to develop and validate such a model. A multicenter cross-sectional study (NCT17122021) was conducted from May 2020 to January 2024 in accordance with the Declaration of Helsinki. A dataset of 10,745 lower limb photographs was collected using smartphones and professional cameras across several Russian clinics, then standardized and anonymized before model training. CEAP clinical class was determined by consensus among three surgeons experienced in phlebology. The AI model IVENUS was developed to automatically assess lower limb photographs and classify early-stage CVD according to the CEAP clinical classification (C0-C2). The model was trained using a deep learning approach based on the Swin Transformer V2 architecture. To improve model robustness and reduce overfitting, Gaussian blurring and color jitter were applied as data augmentation methods during training. The standard performance metrics (sensitivity, recall, specificity, accuracy, and precision) were calculated. The dataset consisted of 673 lower limbs of stage C0, 4445 lower limbs of stage C1, and 5627 lower limbs of stage C2. The overall diagnostic accuracy in the external validation subset of 1622 photographs was 84.8%, with a precision of 84.3%, sensitivity of 84.3%, and specificity of 92.3%. The AI model IVENUS demonstrated high diagnostic value for early-stage CVD, sufficient for its application as a clinical decision support system. Therefore, this model may support patient self-screening and telemedicine triage and may be used by specialists for automated patient routing and tracking of treatment progress.
Endovenous thermal ablation (EVTA) of varicose veins is now the first-line therapy for truncal reflux, yet consensus on peri-procedural pharmacological thromboprophylaxis is lacking. A ten-item, online, anonymized survey was distributed to all 291 members of the Spanish Chapter of Phlebology and Lymphology (CEFyL-SEACV) in February 2024. Items explored respondent demographics, anaesthesia, use, timing, drug choice and duration of pharmacological thromboprophylaxis after EVTA. Results are reported as frequencies. Of 291 surgeons, 120 replied (response rate 41%, 120/291); 110 routinely performed EVTA and formed the analytic sample. Most had >10 years of venous experience (84%, 101/120) and practiced in public (48%, 58/120) or private (44%, 53/120) hospitals. Pharmacological thromboprophylaxis was prescribed by 95.5% (105/110): routinely in 80.9% (89/110) and selectively in 14.5% (16/110). Low-molecular-weight heparin (LMWH) was preferred (92.7%, 102/110); direct oral anticoagulants (DOACs) were rare (6.4%, 7/110). Prophylaxis was initiated immediately post-procedure in 39.1% (41/110), within 1-6 h in 37.1% (39/110) and ≥6 h in 22.9% (24/110). Standard duration was 6-10 days for 69.5% (73/105), whereas patients with pro-thrombotic risk factors frequently received extended courses (≥15 days in 16.2%, 17/105). Spanish vascular surgeons widely adopt pharmacological thromboprophylaxis after EVTA, but timing and duration vary substantially in the absence of definitive guidelines. These findings highlight the need for a national, evidence-based consensus to harmonize practice and optimize patient safety.
Background: Trace elements function as essential micronutrients involved in oxidative balance, mitochondrial activity, and cardiovascular metabolism. Cigarette smoking represents a significant source of toxic metals and may disrupt systemic trace element homeostasis. Alterations in micronutrient and metal balance may contribute to oxidative stress, endothelial dysfunction, and myocardial remodeling, which are central mechanisms in the pathogenesis of heart failure with preserved ejection fraction (HFpEF). This study aimed to investigate whether smokers with HFpEF exhibit distinct hair trace element profiles compared with smokers without HFpEF. Methods: In this prospective pilot study, scalp hair samples were collected from adults undergoing clinical evaluation for suspected cardiovascular disease. Trace element concentrations were determined using inductively coupled plasma mass spectrometry (ICP-MS). Participants were first stratified according to smoking status and subsequently, within the smoker subgroup, according to HFpEF diagnosis based on the Heart Failure Association Pre-test assessment, Echocardiography and natriuretic peptide score (HFA-PEFF) algorithm. Differences in trace element concentrations were analyzed using appropriate statistical tests, with multiple-comparison correction using the Benjamini-Hochberg false discovery rate (FDR). Active smoking was defined as ≥10 cigarettes per day for at least 1 year, and cumulative exposure was quantified in pack-years. Results: Fifty-eight participants were included, including 27 active smokers. In unadjusted analyses, several trace elements differed between smokers with HFpEF and those without HFpEF, including vanadium, lithium, aluminum, and copper. However, after FDR correction, only copper remained significantly elevated in smokers with HFpEF (q = 0.004). Hair copper concentrations were markedly higher in the HFpEF group compared with smokers without HFpEF. These differences were observed alongside echocardiographic features consistent with diastolic dysfunction and structural cardiac remodeling. Conclusions: In this hypothesis-generating pilot study, smokers with HFpEF demonstrated elevated hair copper concentrations, suggesting disturbances in trace element and micronutrient homeostasis. Altered copper metabolism may reflect oxidative stress-related cardiometabolic remodeling associated with HFpEF. These findings raise the hypothesis that cardiometabolic phenotype, rather than smoking exposure alone, may modulate trace element homeostasis in HFpEF; however, causal relationships cannot be established.
ObjectivePhlebolymphedema is a progressive condition caused by combined venous and lymphatic dysfunction. Although complete decongestive therapy (CDT) is widely used in clinical practice, objective evidence regarding its effectiveness across different disease stages is limited. This study aimed to evaluate the short-term effectiveness of CDT in patients with lower extremity phlebolymphedema and to examine the influence of disease stage and body mass index (BMI) on treatment response.MethodsThis retrospective study included patients with phlebolymphedema treated at a tertiary lymphedema clinic between 2020 and 2024. Chronic venous insufficiency was diagnosed by lower-extremity venous duplex Doppler ultrasonography, and lymphatic dysfunction was confirmed by lymphoscintigraphy. All patients completed a standardized intensive CDT program consisting of manual lymphatic drainage, multilayer compression bandaging, and therapeutic exercises for 10 sessions over 2 weeks. Extremity volume was measured using circumferential measurements and calculated with the truncated cone formula. Pre- and post-treatment volumes were compared, and associations with disease stage and BMI were analyzed.Results62 patients (72.2% female), corresponding to 108 affected lower extremities, were analyzed. The mean BMI was 36.5 ± 6.3 kg/m2. CDT resulted in a statistically significant reduction in extremity volume (median reduction: 0.55 L; p < .001). Treatment response differed across disease stages, with greater absolute volume reduction observed in Stage 3 disease (p = .007). A positive correlation was identified between BMI and volume reduction (ρ = 0.322, p = .0007). Age, sex, and history of venous surgery were not associated with treatment response.ConclusionCDT is an effective treatment modality for achieving a significant short-term reduction in extremity volume in patients with phlebolymphedema. Clinically meaningful volume reduction can be achieved across all disease stages, including patients with advanced-stage disease and elevated BMI. These findings support the role of CDT as a primary conservative treatment option in routine phlebolymphedema management.
High-grade serous ovarian cancer (HGSOC) represents the most aggressive subtype of epithelial ovarian cancer and is frequently diagnosed at advanced stages. Increasing evidence suggests that systemic inflammation plays an important role in tumor progression and clinical outcomes. This study aimed to evaluate the association between preoperative systemic inflammatory indices and tumor burden, perioperative outcomes, and recurrence risk in patients with HGSOC undergoing primary debulking surgery. We conducted a retrospective study including 125 patients with histopathologically confirmed HGSOC who underwent primary debulking surgery between January 2020 and December 2025. Preoperative hematological parameters obtained within 24 h before surgery were used to calculate inflammatory indices including the neutrophil-to-lymphocyte ratio (NLR), platelet-to-lymphocyte ratio (PLR), lymphocyte-to-monocyte ratio (LMR), systemic immune-inflammation index (SII), systemic inflammation response index (SIRI), and aggregate index of systemic inflammation (AISI). Associations between inflammatory markers, clinicopathological characteristics, perioperative outcomes, and recurrence were analyzed using non-parametric tests and logistic regression models. The mean patient age was 53.66 ± 9.14 years, and most patients presented with advanced disease (FIGO III-IV: 70.4%). Patients with T3 tumors showed significantly higher monocyte (0.66 vs. 0.50 × 109/L, p = 0.003), neutrophil (5.43 vs. 4.99 × 109/L, p = 0.042), and platelet counts (325 vs. 280 × 109/L, p = 0.006) and lower lymphocyte counts (1.79 vs. 1.96 × 109/L, p = 0.009). Composite inflammatory indices were also increased in advanced disease, including PLR (177 vs. 153, p = 0.009), AISI (492 vs. 341, p = 0.002), and SIRI (1.65 vs. 1.18, p = 0.018). Patients requiring postoperative blood transfusion had higher neutrophil counts (7.65 vs. 4.97 × 109/L, p < 0.001) and elevated SIRI (2.56 vs. 1.55, p < 0.001). Patients with recurrence had significantly higher platelet counts (339 vs. 293 × 109/L, p = 0.001) and SII values (2849 vs. 2586, p = 0.012). In multivariate analysis, SII remained independently associated with recurrence (OR 1.022 per 100-unit increase; 95% CI 1.002-1.043; p = 0.033) together with advanced FIGO stages (OR 2.863; 95% CI 1.011-8.104; p = 0.048). Preoperative systemic inflammatory markers are significantly associated with tumor burden, surgical outcomes, and recurrence risk in HGSOC. An elevated SII appears to be an independent predictor of recurrence and may represent a practical biomarker for improving preoperative risk stratification and postoperative surveillance.
To evaluate the safety and efficacy of Total Endovenous Laser Ablation (TEVLA) in a multicenter cohort. Prospective multicenter non-randomized study including 153 patients (CEAP C2-C6). TEVLA was performed as a single-session procedure treating truncal veins, tributaries, and perforators. Primary endpoint was occlusion rate. Secondary endpoints included complications, pain (VAS), and rVCSS improvement. Occlusion rate was 99.3% at 7 days and 98.3% at 6 months. No DVT or EHIT events were observed. Minor complications included hyperpigmentation (5.9%) and paresthesia (2.6%). Mean rVCSS significantly improved (-3.24 at 1 month; p<0.001). No association was found between LEED and complications. TEVLA is a safe and effective single-step technique with high occlusion rates and low complication profile. Further randomized studies are warranted.
BackgroundLipedema is an adipose disorder associated with multiple impairments. Conservative treatments remain the mainstay of management, yet evidence regarding the effects of physical therapies on clinical, imaging, and body composition outcomes is limited. Radial extracorporeal shock wave therapy (rESWT) has been proposed as a non-invasive therapeutic option, although its impact is not fully established.MethodsThis was a prospective, longitudinal, within-patient study conducted in women with clinically diagnosed lipedema. One lower limb was treated with radial extracorporeal shock wave therapy (rESWT), whereas the contralateral limb served as an internal control. A total of 16 patients were initially assessed, of whom 12 completed the full follow-up and were included in the final analysis. rESWT was applied over six sessions (two sessions per week) using standardized parameters. Clinical outcomes (LEFS, EQ-5D, SF-36 Physical Function, and IPAQ) were assessed at baseline, 6 weeks, and 3 months. Ultrasound and elastography were used to evaluate subcutaneous tissue thickness and stiffness at predefined leg and thigh sites, while segmental bioimpedance analysis assessed body composition and fluid distribution. Longitudinal changes were analyzed using mixed-effects models.ResultsSignificant improvements were observed in functional capacity, quality of life, and physical activity levels at both 6 weeks and 3 months compared with baseline (p < .05). In contrast, no statistically significant changes were detected in ultrasound-derived tissue thickness, elastography measurements, or bioimpedance parameters over time, and no significant differences were detected between treated and control limbs within the constraints of the available sample size.ConclusionsrESWT was associated with meaningful clinical and functional improvements in patients with lipedema, despite the absence of detectable changes in tissue thickness, stiffness, or body composition. These findings suggest that the benefits of rESWT may be mediated through symptom modulation and functional adaptation rather than structural tissue modification, supporting its role as part of conservative, symptom-oriented treatment strategies in lipedema.
Acute cholecystitis, a leading cause of urgent surgical intervention, poses challenges in predicting severity and operative complexity. This study characterized the immuno-inflammatory profile distinguishing acute from chronic cholecystitis and assessed whether blood-derived ratios-neutrophil-to-lymphocyte (NLR), monocyte-to-lymphocyte (MLR), and platelet-to-lymphocyte (PLR)-correlate with histologic severity and surgical difficulty. The study retrospectively analyzed 759 patients undergoing cholecystectomy from 2016 to 2024. Inflammatory indices from preoperative bloodwork were compared across histopathologic subtypes (catarrhal, phlegmonous, gangrenous), clinical features, and surgical outcomes, including conversion to open procedure. Logistic regression and ROC analyses identified predictors of acute inflammation and conversion. Acute cholecystitis patients showed elevated NLR (7.0 vs. 3.1), MLR (0.44 vs. 0.26), and PLR (194 vs. 142; all p < 0.001). NLR was the only independent predictor of acute disease (OR = 1.29, 95% CI 1.203-1.390, p < 0.001), with superior discrimination (AUC = 0.806, cut-off = 3.56; sensitivity 73.1%, specificity 80.4%). NLR and PLR rose progressively from catarrhal to phlegmonous and gangrenous subtypes (p < 0.05), mirroring conversion rates (0% catarrhal, 3.2% phlegmonous, 10.5% gangrenous; p = 0.001). Routine hematologic ratios capture systemic immune activation in acute cholecystitis, reflecting histologic severity and operative risk. NLR, integrating innate and adaptive immune dynamics, offers a practical biomarker for preoperative risk stratification in acute care surgery.
BackgroundDeep vein thrombosis (DVT) is associated with inflammatory response that may contribute to incomplete venous recanalization and post-thrombotic syndrome (PTS). Diosmin, a venoactive flavonoid, may provide additional benefit when combined with standard anticoagulation.ObjectivesTo evaluate whether adjunctive diosmin therapy reduces inflammation, improves recanalization, enhances quality of life, and decreases PTS severity in acute DVT.MethodsThis retrospective cohort study analyzed 612 patients with acute proximal DVT receiving anticoagulation alone (control, n = 298) or anticoagulation plus diosmin 600 mg daily (n = 314). Propensity score matching (1:1) yielded 230 pairs. C-reactive protein (CRP), neutrophil-to-lymphocyte ratio (NLR), and erythrocyte sedimentation rate (ESR) were assessed at baseline and day 30. Recanalization was evaluated by duplex ultrasound at 3 and 12 months. Quality of life was measured using VEINES-QOL, and PTS was assessed using the Villalta scale at 12 months.ResultsThe diosmin group showed greater reductions in CRP (-13.9 vs -11.8 mg/L; p = 0.038), NLR (-1.72 vs -1.43; p = 0.019), and ESR (-17.2 vs -14.1 mm/hr; p = 0.031) at day 30. Complete recanalization rates were higher with diosmin at 12 months (91.3% vs 76.5%; p < 0.001). VEINES-QOL scores were better in the diosmin group at 12 months (71.8 ± 13.2 vs 66.9 ± 12.6; p = 0.024). While overall PTS incidence was similar (14.9% vs 16.3%; p = 0.72), moderate-to-severe PTS was less frequent with diosmin among PTS patients (21% vs 40%; Fisher's exact p = 0.062), suggesting a trend that requires confirmation.ConclusionsAdjunctive diosmin was associated with greater inflammatory marker reductions, improved recanalization, and better quality of life. A trend toward reduced PTS severity was observed but should be interpreted cautiously given the small number of events. Prospective randomized trials are needed to confirm these findings.
Background/Objectives: Perioperative risk stratification in cardiac surgery is based mainly on static preoperative variables and therefore does not fully capture dynamic multiorgan responses to surgical stress. The Model for End-Stage Liver Disease (MELD) score, which integrates bilirubin, creatinine, and the international normalized ratio (INR), reflects hepatorenal function, but its perioperative dynamics remain insufficiently explored. This study aimed to characterize perioperative MELD trajectories in patients undergoing off-pump coronary artery bypass grafting (OPCAB) and to assess the influence of sex and diabetes mellitus on these changes and their clinical relevance. Methods: This retrospective observational study included 111 patients undergoing elective OPCAB. MELD scores were assessed preoperatively (MELD0), on postoperative day 1 (MELD1), and on day 6 (MELD6). Dynamic indices of MELD change were calculated, including the early postoperative increase (ΔMELD01). The effects of sex and diabetes mellitus on MELD trajectories were analyzed using multivariable linear regression and generalized estimating equations. A high-surge phenotype was defined as the upper quartile of ΔMELD01. Results: MELD increased significantly on postoperative day 1 and partially recovered by day 6 (p < 0.001). Female sex was independently associated with lower postoperative MELD values (β = -2.54, p < 0.001) and a smaller ΔMELD01, whereas diabetes mellitus was associated with a reduced MELD rise (β = -1.07, p = 0.028). Patients with a high-surge MELD phenotype had significantly longer hospitalization than those with a lower MELD response (12.8 ± 2.1 vs. 9.2 ± 1.2 days, p < 0.001). Conclusions: Perioperative MELD trajectories reflect a dynamic hepatorenal stress response after OPCAB and may improve identification of clinically relevant physiological vulnerability.
BackgroundStasis dermatitis with hyperpigmented skin lesions is a distressing condition for patients with chronic venous hypertension. There are no randomized studies evaluating lasers for the treatment of these patients. Lasers can be an attractive option for treating hyperpigmentation associated with stasis dermatitis.MethodsThis prospective, randomized, 3-arm, open-label, vehicle-controlled study will enroll patients scheduled to undergo treatment for stasis dermatitis with hyperpigmented skin lesions. Patients will be allocated to either Q-switched Nd: YAG 1064 nm short-pulse nanoseconds, Nd: YAG 1064 nm ultra-short-pulse picoseconds, or cold cream vehicle control. All treatments are scheduled for six visits with pre-defined dates, with a final follow-up visit at 28- to 35-days intervals. Primary outcomes include colorimetry analysis, secondary outcomes pre- and post-photographic analysis, and DLQI quality-of-life assessment.ConclusionsThe results of this trial will provide high-quality evidence to guide clinical practice on optimal management of hyperpigmented skin lesions secondary to stasis dermatitis.
BackgroundLipedema is a chronic, progressive adipose tissue disorder affecting mainly women, characterized by bilateral, disproportionate fat accumulation in the lower extremities. The condition is often associated with pain, heaviness, and functional limitations. While the adipose tissue changes in lipedema are well-described, its impact on muscle mass, strength, and functional performance remains underexplored. This study aimed to evaluate the prevalence of sarcopenia and its relationship with lipedema severity.Materials and methodsA cross-sectional observational study was conducted on 48 women with clinically diagnosed lower-extremity lipedema. Diagnosis followed the International Lipoedema Association and German S2k guidelines. Sarcopenia was assessed using a multidimensional approach, including ultrasonographic rectus femoris thickness, handgrip strength, the Five Times Sit-to-Stand Test, and four-m walking speed. The lipedema stage was determined using morphological criteria. Statistical analyses evaluated the relationships between sarcopenia, functional parameters, and lipedema stage.ResultsParticipants had a mean age of 47.2 ± 8.4 years and a BMI of 33.0 ± 4.3 kg/m2. Sarcopenia was identified in 33.3% of participants, with 14.6% classified as severe. Those with sarcopenia exhibited lower rectus femoris thickness and slower walking speed (p < .05). Advancing lipedema stage correlated with reduced muscle thickness, weaker handgrip strength, slower gait, and prolonged Five Times Sit-to-Stand Test duration (p < .05). Stage 3 patients demonstrated the highest prevalence of sarcopenia, indicating progressive impairment in muscle mass and functional performance with disease severity (p < .05). No significant associations were found between age or BMI and muscle parameters (p > .05).ConclusionsSarcopenia is prevalent in women with lower-extremity lipedema and increases with disease stage. Comprehensive musculoskeletal assessment should be integrated into lipedema management to address functional impairment and optimize patient care.
BackgroundThis study aims to systematically evaluate the current landscape of artificial intelligence (AI) and machine learning applications in lymphedema research by employing bibliometric and altmetric analyses. The goal is to identify major trends, research focuses, and influential contributors in this rapidly evolving field.MethodA total of 43 AI-related articles on lymphedema published between 1975 and 2025 were retrieved from the Web of Science Core Collection. Bibliometric indicators such as publication years, journals, countries, authorship, and citation metrics were analyzed. Altmetric scores were also assessed. Each study was classified by study type and thematic focus.ResultOriginal research articles constituted the majority (n = 26), with clinical studies being the most common subtype. The United States and China led in publication output. Most studies were published in Q1-Q2 journals, indicating high scientific quality. Scientific Reports was the most productive journal. General AI applications and risk prediction emerged as dominant themes. A moderate positive correlation was found between average annual citations and altmetric scores (r = 0.470, p = 0.039), suggesting consistency between academic impact and online visibility.ConclusionThis is the first study to comprehensively map AI-based research in the field of lymphedema using bibliometric and altmetric methods. The findings reveal increasing global interest and high-impact publications, particularly in the domains of risk prediction and early diagnosis. These insights may guide future methodological frameworks and interdisciplinary collaborations in this emerging field.
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ObjectiveLipedema, which mainly affects women, is a chronic and progressive disorder characterized by abnormal adipose tissue accumulation in the limbs. Despite its clinical importance, research on lipedema remains limited. Bibliometric analysis provides a quantitative way to evaluate the literature, identify trends, and assess research impact.Materials and methodsGlobal lipedema research was analyzed in the Web of Science database using the terms "lipedema", "lipoedema", and "lipolymphedema" for publications indexed through March 2025. Articles were classified by publication type, year, country of origin, journal quartile, and citation count. Citation analyses excluded publications from 2024 and 2025 because citation accumulation was incomplete. Only English original articles and reviews were included, while editorials, meeting abstracts, and non-indexed sources were excluded.ResultsOf 610 records identified, 382 met the inclusion criteria. The analysis identified the main contributing countries and highlighted knowledge gaps and opportunities for multidisciplinary collaboration in the evolving field of lipedema research.ConclusionsThis study provides a global overview of lipedema-related research and its scholarly development. It also highlights the need for further studies on the pathophysiology, diagnosis, and treatment of lipedema.
ObjectivesEndovenous radiofrequency ablation (RFA) is an established minimally invasive treatment for saphenous vein insufficiency. This study evaluated 1-year clinical and anatomical outcomes of RFA in a real-world cohort, including staged adjunctive interventions when indicated.MethodsThis retrospective study initially evaluated 99 patients with symptomatic saphenous vein insufficiency. Of these, 84 patients, corresponding to 90 treated limbs, completed follow-up and were included in the final analysis. Among these, 74 patients underwent great saphenous vein (GSV) ablation (including 6 bilateral procedures, totaling 80 limbs), and 10 patients underwent small saphenous vein (SSV) ablation. Clinical outcomes were assessed using the Venous Clinical Severity Score (VCSS), while Clinical-Etiology-Anatomy-Pathophysiology (CEAP) classification was used to describe baseline disease severity.ResultsThe overall occlusion rate across all treated limbs was 88/90 (97.7%). In the GSV subgroup, mean VCSS decreased significantly from 6.0 ± 1.5 at baseline to 2.2 ± 1.2 at 12 months (p < .001). In the SSV subgroup, mean VCSS decreased from 5.5 ± 0.5 to 2.0 ± 1.0, demonstrating comparable clinical improvement. Ten limbs (12.5% of the GSV limbs) required adjunctive sclerotherapy for symptomatic residual tributaries. Minor complications included transient paresthesia in 7 limbs (7.7%), all of which resolved during follow-up. One patient (1.2%) developed Ablation-Related Thrombus Extension (ARTE), which was managed conservatively without sequelae.ConclusionEndovenous RFA provided high occlusion rates, significant clinical improvement, and a favorable safety profile at 1 year. These findings support RFA as an effective treatment option for both GSV and SSV insufficiency in routine clinical practice.