Massachusetts Chapter of the American College of Surgeons

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Outpatient Varicose Veins Surgery in the Elderly; Safe and Effective
Lindsey M. Korepta MD1, James B. Knox MD2, Michael Belkin MD1
1Brigham and Women's Hospital, Boston, MA 2Falmouth Hospital, Boston, MA

Background: A detailed analysis of elderly patients undergoing various forms of vein procedures with long-term analysis has yet to be reported.
Methods: Data was collected retrospectively on patients 70 years of age and older who underwent outpatient venous interventions at a single institution from January 2016 to July 2019. Interventions included sclerotherapy, truncal venous ablation (cyanoacrylate closure (VenaSeal), radiofrequency ablation (RFA), or endovenous laser ablation (EVLT)), and phlebectomy. Preprocedural and postprocedural CEAP classification and VCSS were recorded. Paired t-tests were performed on change in CEAP classification and VCSS scores. Local and systemic complications were recorded for each patient.
Results: There were 105 legs treated in 79 patients for a total of 137 interventions (51 truncal vein ablations, 14 phlebectomies, 72 sclerotherapies). Of these, 17 patients underwent Venaseal, 33 EVLT, and 1 RFA. After intervention, 11 patients (15 legs) were lost to follow-up and dropped from the analysis. Average follow-up was 171 days (range 3-998), median age at intervention was 75 years, and 22% of the interventions were performed on therapeutic anticoagulation. There were 3.6% systemic complications, all of which were a hypersensitivity reaction to cyanoacrylate glue. There was a statistically significant difference in pre and post intervention CEAP and VCSS scores (p


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