Radio-frequency stylet ablation for incompetent perforating veins

I read the recent publication by van den Bos et al. ¹ with a great interest. van den Bos et al. ¹ reported that ‘RFA of IPV may be a promising procedure, but patient and incompetent perforator vein selection is important and further standardization of the procedure is required’. Due to the nature of preliminary report, the generalization of the result to real clinical practice is limited. van den Bos et al. failed to give the complete data on the attempt and difficulty in procedure performing. In addition, the use of a subjective tool, self-reported side-effect monitoring might be a critical point of this work. Indeed, there are some recent publications focusing on using RFS ablation for the management of IPV. Good outcome of using RFA for IPV is reported in some previous literatures. ^2,3 Hingorani et al. ² reported that a pulsatile venous flow pattern was a significant predictor of failure following RFS for IPVs.