Eight studies (n=419) were included in the review: six randomised controlled trials (RCTs) (n=287), one non-RCT (n=102) and one retrospective study (n=30). One RCT scored 4, three RCTs scored 3, one RCT scored 2 and one RCT scored 1 on the Jadad scale.
Significant benefits were reported for radiofrequency obliteration in terms of ecchymosis at one week (OR 0.26, 95% CI 0.10 to 0.67; number of RCTs not reported) and haematoma at 72 hours (OR 0.16, 95% CI 0.04 to 0.59, I2=32.4%; three RCTs), one week (OR 0.15, 95% CI 0.06 to 0.38; number of RCTs not reported) and three weeks (OR 0.16, 95% CI 0.04 to 0.60; number of RCTs not reported). No significant differences were reported between radiofrequency obliteration and conventional surgery in terms of overall postoperative complications at four months (two RCTs) and in most individual complications at earlier time points (seven RCTs).
No significant differences were reported for the effectiveness of treatments in terms of immediate or complete great saphenous vein occlusion, incomplete great saphenous vein closure and abolition of reflux at any time up to two years, recurrent varicose veins and re-opening at two years, and neovascularisation.
All studies that measured quality of life (six studies) revealed improvements following radiofrequency obliteration. The authors specifically drew attention to return to normal activity (WMD -2.83, 95% CI -4.41 to -1.25; number of RCTs not reported) and return to work (OR -7.19, 95% CI -9.59 to -4.78; four RCTs; there was a discrepancy in the paper for this result).
Significant heterogeneity was reported for the outcomes of reflex, pain and global score of quality of life. There was no significant heterogeneity for all other outcomes measured in more than one study. Publication bias was not considered to be a threat.