Thirty-day rehospitalization after saphenous vein treatment in France: a nationwide observational study.

INTRODUCTION: Endovenous thermal ablation (EVTA) has become increasingly used for treatment of saphenous vein incompetence. However, severe adverse events leading to rehospitalization remain insufficiently characterized in large real-world populations. This study aimed to evaluate 30-day rehospitalization after great saphenous vein (GSV) and small saphenous vein (SSV) interventions in France and to compare outcomes between EVTA and surgery. METHODS: We conducted a nationwide observational study using the French National Health Data System (SNDS). Adult patients undergoing GSV or SSV intervention between January 2020 and November 2024 were identified using International Classification of Diseases (ICD-10) and Common Classification of Medical Acts (CCAM). The primary outcome was all-cause 30-day rehospitalization after discharge. Secondary outcomes included rehospitalization for thromboembolic events, major bleeding, infection, and other procedure-related complications. Multivariable logistic regression analyses were performed to identify factors associated with rehospitalization. RESULTS: A total of 450,202 patients underwent saphenous vein intervention, including 65,485 SSV and 384,717 GSV procedures. EVTA represented 77.3% of SSV interventions and 83.4% of GSV interventions. Thirty-day rehospitalization occurred in 1.2% of patients after SSV treatment and 4.3% after GSV treatment. Rehospitalizations due to thromboembolic complications were exceptionally rare (0.01% after SSV treatment and 0.03% after GSV treatment), while major bleeding and infectious complications were nearly absent. For SSV interventions, treatment modality was not independently associated with rehospitalization after adjustment. For GSV interventions, surgery was associated with a lower risk of 30-day rehospitalization compared with EVTA (adjusted OR 0.54, 95% CI 0.41-0.71). Among patients treated with EVTA for GSV incompetence, no difference was observed between endovenous laser ablation and radiofrequency ablation (adjusted OR 0.97, 95% CI 0.81-1.16). CONCLUSIONS: In this nationwide French cohort, 30-day rehospitalization after saphenous vein intervention was uncommon and severe complications requiring rehospitalization were exceptionally rare. EVTA was the predominant treatment modality and demonstrated an excellent safety profile. Rehospitalization appeared to be influenced primarily by patient characteristics rather than major procedure-related complications, supporting the safety of contemporary treatment strategies for both GSV and SSV incompetence.