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April 19, 2026

Endovenous microwave ablation versus high ligation and stripping for the treatment of small saphenous vein incompetence. A single center retrospective study

Key Points

To compare the effectiveness and safety of endovenous microwave ablation (EMA) and high ligation and stripping (HLS) for small saphenous vein insufficiency.
Conducted a single-center retrospective study
Enrolled patients with small saphenous vein insufficiency treated with EMA or HLS
Assessed clinical severity using CEAP and VCSS
Evaluated quality of life using AVVQ and CIVIQ-14
Used propensity score matching to minimize confounding
EMA led to a significantly shorter operative time compared to HLS (p < 0.001)
Patients in the EMA group had more rapid symptom improvement and higher clinical severity score reductions (p < 0.01)
Lower rates of paresthesia and numbness were reported in the EMA group compared to HLS (p < 0.05)
No significant differences in long-term quality of life and safety indicators between groups (p > 0.05)

Abstract

BackgroundThe objective of this study was to compare the efficacy and safety of endovenous microwave ablation (EMA) and high ligation and stripping (HLS) for the treatment of small saphenous vein insufficiency..MethodsThis single-center retrospective study consecutively enrolled patients with small saphenous vein insufficiency who underwent either endovenous microwave ablation (EMA) or high ligation and stripping (HLS). Clinical severity was assessed using the Clinical-Etiology-Anatomy-Pathophysiology (CEAP) classification and the Venous Clinical Severity Score (VCSS). Quality of life was evaluated using the Aberdeen Varicose Vein Questionnaire (AVVQ) and the Chronic Venous Insufficiency Questionnaire-14 (CIVIQ-14). Perioperative complications and vein closure rates were recorded. The primary outcome was technical and anatomical vein closure at 6 and 12 months postoperatively. Secondary outcomes included operative time, postoperative complications, symptom improvement, and quality-of-life changes. Propensity score matching was performed to minimize baseline confounding between groups.The objective of this study was to compare the efficacy and safety of endovenous microwave ablation (EMA) and high ligation and stripping (HLS) for the treatment of small saphenous vein insufficiency.ResultsFollowing propensity score matching (PSM), the baseline characteristics between the two groups were comparable. EMA demonstrated a significantly shorter operative time compared to HLS (p p p p > 0.05).ConclusionThe study findings confirm that endovenous microwave ablation (EMA) significantly improves quality of life in patients with small saphenous vein (SSV) insufficiency. Compared to high ligation and stripping (HLS), EMA demonstrates superior minimally invasive characteristics, facilitates faster recovery, and provides better symptom relief within the first year post-procedure. Furthermore, its long-term safety profile is non-inferior to HLS, collectively resulting in higher patient satisfaction.

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Endovenous microwave ablation versus high ligation and stripping for the treatment of small saphenous vein incompetence. A single center retrospective study

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