ClariVein™ – One year results of mechano-chemical ablation for varicose veins in a multi-ethnic Asian population from Singapore

Khor, Shao Nan; Jiang, Lei; Kam, Jia Wen; Kum, Steven; Tan, Yih Kai; Tang, Tjun Yip

doi:10.1177/0268355518771225

Cited by 15 publications

(13 citation statements)

References 19 publications

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“…Gibson and Ferris showed similar degree of patient satisfaction and very low pain scores in their WAVES study, 10 which is comparable to MOCA. 20,21 Reasons for this are that VSCS and MOCA are performed without tumescent anaesthesia and requires only one injection with local anaesthesia at the injection site. Furthermore, there is no potential risk of thermal-related injuries to surrounding nerves or tissues.…”

Section: Discussionmentioning

confidence: 99%

Endovenous cyanoacrylate glue to treat varicose veins and chronic venous insufficiency—Experience gained from our first 100+ truncal venous ablations in a multi-ethnic Asian population using the Medtronic VenaSeal™ Closure System

et al. 2019

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Objectives The aim of this prospective single-centre study is to assess the effectiveness and patient experience of the VenaSeal™ Closure System, a novel non-thermal, non-tumescent catheter technique, which uses cyanoacrylate glue to occlude the refluxing truncal superficial veins to treat varicose veins and chronic venous insufficiency, in a multi-ethnic Asian population from Singapore. Methods Seventy-seven patients (93 legs; 103 procedures) underwent VenaSeal™ Closure System ablation. Forty-nine (63.6%) for great saphenous vein incompetence, 16 (20.8%) bilateral great saphenous vein, 2 (2.6%) small saphenous vein and 10 (13.0%) combined unilateral great saphenous vein and small saphenous vein/anterior thigh vein reflux. In addition, 65/93 legs (69.9%) had C4–C6 disease. Patients were reviewed at 2 weeks, 3, 6 and 12 months post-procedure. Results There was 100% technical success. 28/77 (36.4%) underwent concomitant phlebectomies. All procedures were well tolerated with a mean post-operative pain score of 3.0 (range: 0–5). After three months, median patient satisfaction was 9.0 (interquartile range: 7.0–10.0). At two-week follow-up, the great saphenous vein was completely occluded in 88/88 (100%) veins and small saphenous vein completely closed in 11/11 (100%) veins. At three-month follow-up, the great saphenous vein was occluded in 51/53 (96.2%) veins and small saphenous vein completely closed in 5/5 (100%) veins. At six-month follow-up, the great saphenous vein was completely occluded in 42/45 (93.3%) veins and small saphenous vein completely closed in 5/7 (71.4%) veins. At one year, great saphenous vein and small saphenous vein occlusion rates were 54/59 (91.5%) and 5/8 (62.5%), respectively. There was one deep vein thrombosis. Transient superficial phlebitis was reported in 10/93 (10.8%) legs, which were all self-limiting. There were 9/103 (8.7%) anatomical recurrences, but no patients required re-intervention as they were asymptomatic. Conclusions Cyanoacrylate glue is a safe and efficacious modality to ablate refluxing saphenous veins in Asian patients in the short term. There is a high satisfaction rate and peri-procedural pain is low. Early results are promising but further evaluation and longer term follow-up are required.

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Section: Discussionmentioning

confidence: 99%

Endovenous cyanoacrylate glue to treat varicose veins and chronic venous insufficiency—Experience gained from our first 100+ truncal venous ablations in a multi-ethnic Asian population using the Medtronic VenaSeal™ Closure System

et al. 2019

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“…28 Our results have also shown that Asians tend to have more concomitant GSV and SSV reflux. If treating both simultaneously, which has been the trend in Singapore, 16 perhaps would favour the use of an NTNT technique, where venous reflux can be treated with little risk to the adjacent superficial nerves, i.e. saphenous nerve for the GSV and sural nerve for the SSV.…”

Section: Discussionmentioning

confidence: 99%

“…15 Our own data from Singapore have shown that the truncal saphenous veins tend to be smaller in diameter and may well lend itself nicely for NTNT ablation to allow easier vein closure with a more minimally invasive technique compared to EVLA or RFA. 16 The aim of this study is to investigate whether there are differences between Caucasian and Asians from two disparate cohorts in the world, with regard to their pre-operative venous reflux patterns and truncal vein characteristics, which could potentially help clinicians tailor venous treatment on a more individualised basis in different parts of the world.…”

Section: Introductionmentioning

confidence: 99%

A comparison between Caucasian and Asian superficial venous anatomy and reflux patterns – Implications for potential precision endovenous ablation therapy

et al. 2019

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Objectives The aim of this study is to investigate whether there are differences between predominantly Caucasians and Asians from two disparate cohorts around the globe, with regard to their pre-operative venous reflux patterns and truncal vein characteristics, which could potentially help clinicians tailor venous treatment for chronic venous insufficiency on a more individualised basis in different parts of the world. Methods A total of 200 lower limb chronic venous insufficiency duplex studies (127 Singaporean (predominantly Asian) patients) and 200 lower limb chronic venous insufficiency duplex scans (137 Americans predominantly Caucasians) were analysed and compared for differences in venous anatomy and reflux characteristics. Results Asian patients from Singapore presented with higher CEAP scores compared to the predominantly Caucasian cohort from the US (30% CEAP 4a or greater vs. 17.5%; p < 0.01). Singaporeans had more great saphenous vein reflux starting at the sapheno-femoral junction (86% vs. 73%; p < 0.01) and ending at the ankle (93% vs. 46%; p < 0.01). Vein diameters were generally larger in the US cohort of patients (median 5.7 mm vs. 2.9 mm; p < 0.01). Conclusions The predominantly Asian cohort from Singapore had smaller diameter truncal veins, longer segments of truncal vein reflux and present later with more advanced chronic venous insufficiency compared to their American counterparts. This information could help tailor endovenous ablation on a more individualised basis in the future.

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“…The maximum daily doses for sclerosant injection shall be observed. In several case series and non-randomised studies, high initial occlusion rates and little pain were reported [170][171][172][173][174][175].…”

Section: Mechanochemical Endovenous Ablation (Moca)mentioning

confidence: 99%

Sclerotherapy in the treatment of varicose veins

Rabe

Breu²,

Flessenkämper³

et al. 2020

Hautarzt

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Sclerotherapy in the treatment of varicose veins S2k guideline of the Deutsche Gesellschaft für Phlebologie (DGP) in cooperation with the following societies: DDG, DGA, DGG, BVP These guidelines are also consistent with the results of the first European guidelines for sclerotherapy dating from 2012 [1]. These guidelines consider the current state of the literature, but not in every case the different conditions of approval of the various drugs.

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ClariVein™ – One year results of mechano-chemical ablation for varicose veins in a multi-ethnic Asian population from Singapore

Abstract: Early results are similar to what is described so far in the mechano-chemical ablation literature but recurrences are more than expected at one year. This is disappointing but is tempered by the fact that the majority of patients were asymptomatic and required no reintervention.

Cited by 15 publications

References 19 publications

Endovenous cyanoacrylate glue to treat varicose veins and chronic venous insufficiency—Experience gained from our first 100+ truncal venous ablations in a multi-ethnic Asian population using the Medtronic VenaSeal™ Closure System

Endovenous cyanoacrylate glue to treat varicose veins and chronic venous insufficiency—Experience gained from our first 100+ truncal venous ablations in a multi-ethnic Asian population using the Medtronic VenaSeal™ Closure System

A comparison between Caucasian and Asian superficial venous anatomy and reflux patterns – Implications for potential precision endovenous ablation therapy

Sclerotherapy in the treatment of varicose veins

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