Presentation (CTI)

OBJECTIVES: Superficial venous procedures are widely used in the management of chronic venous disease, aiming to relieve patients’ symptoms and improve quality of life. In this retrospective observational study, we assess the incidence of adverse events among patients receiving a superficial venous procedure. Safety of superficial venous treatments has been shown to be safe in clinical trials; however real-world event rates have not been systematically studied across the different treatments.
METHODS: We conducted a longitudinal study using Medicare Fee-for-Service claims from 2018 - 2023. Superficial venous procedures and post-procedure complications were identified with CPT and ICD-10 codes. Procedures of interest include radiofrequency ablation, cyanoacrylate, laser, foam sclerotherapy, mechanochemical ablation, and adjunct procedures such as sclerotherapy and phlebectomy. Patients were categorized into ten mutually exclusive groups based on receipt of a single procedure or combination of procedures. Short-term complications were identified within 90 days of the index procedure, and long-term complications were within 6 months. Adverse event rates were calculated as the percentage of patients with events of interest out of the total cohort and were unadjusted.
RESULTS: We identified 15,699 patients who received superficial venous procedures during the study period. Short-term complications such as immune responses and infections were rare (0.36% and 0.64% overall, respectively). Granuloma formation was also infrequent, being less than 0.07% overall. For long-term complications, including amputation, deep vein thrombosis, pulmonary embolism, stroke, and superficial venous thrombosis, event counts were <11 across all groups. Rates of adverse events were similar across procedure groups.
CONCLUSIONS: Our findings demonstrate consistently low rates of adverse events across all groups, indicating that superficial venous procedures are generally safe in routine clinical practice.