&lt;p&gt;ClariVein&lt;sup&gt;®&lt;/sup&gt;, mechanochemical endovenous ablation: patient selection and perspective&lt;/p&gt;

Belramman, Amjad; Bootun, Roshan; Onida, Sarah; Davies, Alun H.; Lane, Tristan

doi:10.2147/jvd.s167491

Cited by 3 publications

(2 citation statements)

References 23 publications

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“…Recanalization seems to be more likely in the larger veins with preoperative diameter of over 7 millimetres. There are no guidelines on the maximum vein size in MOCA, but according to a recent review, Clarivein® catheter can be used in veins with diameter of up to 20-24 mm: the rotating tip can in such veins still reach the vein wall 20 . The observed recanalization rate and the tendency of large veins to recanalize is comparable to the one-year results of this study 17 .…”

Section: Discussionmentioning

confidence: 99%

Three-year results of a randomized controlled trial comparing mechanochemical and thermal ablation in the treatment of insufficient great saphenous veins

Vähäaho

Halmesmäki

Mahmoud

et al. 2021

Journal of Vascular Surgery: Venous and Lymphatic Disorders

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Section: Discussionmentioning

confidence: 99%

Three-year results of a randomized controlled trial comparing mechanochemical and thermal ablation in the treatment of insufficient great saphenous veins

Vähäaho

Halmesmäki

Mahmoud

et al. 2021

Journal of Vascular Surgery: Venous and Lymphatic Disorders

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“…Endovenous ablation with catheter-based technologies has led to a paradigm shift from open surgery, allowing specialists to perform them in an outpatient or office-based setting . Currently, both the National Institute of Clinical Excellence and the American Venous Forum recommend endovenous thermal ablations (ETAs), namely, radiofrequency ablation and endovenous laser ablation, as the first-line treatment of saphenous veins reflux . ETAs demonstrate a short recovery time and are cost-effective compared with open surgery.…”

Section: Introductionmentioning

confidence: 99%

Pain Outcomes Following Mechanochemical Ablation vs Cyanoacrylate Adhesive for the Treatment of Primary Truncal Saphenous Vein Incompetence

et al. 2022

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IMPORTANCE Endovenous thermal ablations (ETAs) are recommended as first-line treatment for truncal vein reflux, have a short recovery time, and are cost-effective. However, ETAs are associated with discomfort during tumescent anesthesia infiltration. To minimize discomfort, nonthermal, nontumescent ablation techniques had emerged in the form of mechanochemical ablation (MOCA) and cyanoacrylate adhesive injection (CAE).OBJECTIVE To assess pain scores immediately after truncal ablation using a 100-mm visual analog scale and 10-point number scale to compare pain-related outcomes following mechanochemical ablation vs cyanoacrylate adhesive treatment. DESIGN, SETTING, AND PARTICIPANTSThe Multicenter Randomized II Clinical Trial Comparing Mechanochemical Ablation vs Cyanoacrylate Adhesive for the Treatment of Primary Truncal Saphenous Veins Incompetence study was a prospective multicenter randomized clinical trial conducted at 3 sites between November 2017 and January 2020. Inclusion criteria were primary great or small saphenous varicose veins; exclusion criteria included recurrent varicose veins, current deep venous thrombosis, or serious arterial disease. There were 392 participants screened, 225 were excluded, and 167 participants underwent randomization. Four participants did not receive allocated intervention and were included in the intention-to-treat analysis. Follow-up took place at 2 weeks, and 3, 6, and 12 months.INTERVENTIONS Patients with primary truncal vein incompetence were randomized to receive either MOCA or CAE. MAIN OUTCOMES AND MEASURESThe primary outcome measure was pain score immediately after completing truncal ablation using a 100-mm visual analog scale (VAS) and a 10-point number scale. Secondary outcome measures included degree of ecchymosis, occlusion rates, clinical severity, and generic and disease-specific quality of life (QoL) scores.RESULTS Of 167 study participants, 99 (59.3%) were women, and the mean (SD) age was 56 (15.8) years. Overall, 155 truncal veins treated (92.8%) were great saphenous veins. Demographic data and baseline status were comparable between treatment groups. A total of 73 patients (47%) underwent adjunctive treatment of varicosities. Overall median (IQR) maximum pain score after truncal treatment was 23 mm (10-44) on the VAS and 3 (2-5) on the number scale, showing no significant difference in median (IQR) pain measured by VAS (MOCA,] mm vs CAE, 20 [9.0-42.0] mm; P = .23) or by number scale (MOCA,(4)(5) vs CAE, 3 [2-4]; P = .18). Both groups demonstrated significant and comparable improvement in clinical severity, generic and disease-specific QoL scores, and complete occlusion rates. Four patients treated with CAE developed minor complications (superficial thrombophlebitis and thrombus extensions). CONCLUSIONS AND RELEVANCE To our knowledge, this was the first randomized clinical trial directly comparing nontumescent ablation techniques. The study demonstrated that the MOCA and CAE techniques have a similar periprocedural pain score. TRIAL REGISTRATION ClinicalTrial...

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Interventions for great saphenous vein insufficiency: A systematic review and network meta-analysis

Juhani,

Abdullah,

Alyaseen

et al. 2024

Vascular

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Background Great saphenous vein insufficiency (GSVI) adversely affects the quality of life of affected individuals. Minimally invasive endo-venous ablation techniques have emerged as effective and safe treatments, despite the longstanding use of surgical interventions. We aim in our study to evaluate all the available interventions in the literature, either endo-venous or conventional approaches for the treatment of GSVI. Methods A thorough search was performed across four electronic databases to identify relevant studies. A frequentist network meta-analysis (NWM) was executed on the combined data to derive network estimates pertaining to the outcomes of concern. Risk ratios (RRs) were employed as the effect size metric for binary outcomes, while mean differences (MDs) were utilized for continuous outcomes, each reported with a 95% confidence interval. The qualitative review was conducted employing the Cochrane risk of bias assessment tool 1. Results Our NWM included 75 studies encompassing 12,196 patients. Regarding technical success rate within the first 5 years after treatment, Endo-venous Laser Ablation (EVLA) with High Ligation and Stripping (HL/S), EVLA alone, Cyanoacrylate Adhesive Injection, cryostripping, HL/S and Radiofrequency Ablation (RFA) were significantly better than Ultrasound-Guided Foam Sclerotherapy and F-care. Also, invagination stripping was inferior to all interventions. Conservative Hemodynamic Cure for Venous Insufficiency and Varicose Veins (CHIVA) demonstrated a significantly lower recurrence rate with a RR of 0.35 [0.15; 0.79] compared to RFA, but RFA was more effective in recurrence prevention than HL/S and Mechanochemical Ablation (MOCA), with a RR of 0.63 [0.41; 0.97] and 0.18 [0.03; 0.95], respectively. Endo-venous Steam Ablation (EVSA) emerged as the most effective in reducing post-intervention pain, showing a MD of −2.73 [−3.72; −1.74] compared to HL/S. In Aberdeen Varicose Vein Questionnaire outcome, our analysis favored MOCA over most studied interventions, with an MD of −6.88 [−12.43; −1.32] compared to HL/S. Safety outcomes did not significantly differ among interventions. Conclusion Our findings revealed significant variations in the technical success rates, recurrence rates, and post-intervention pain levels among different interventions. CHIVA exhibited enhanced performance in terms of lower recurrence rates, while EVSA emerged as a promising choice for mitigating post-intervention pain. Additionally, our analysis underscored the significance of patient-reported outcomes, with MOCA consistently yielding favorable results in terms of enhancing quality of life and expediting the return to regular activities.

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<p>ClariVein<sup>®</sup>, mechanochemical endovenous ablation: patient selection and perspective</p>

Cited by 3 publications

References 23 publications

Three-year results of a randomized controlled trial comparing mechanochemical and thermal ablation in the treatment of insufficient great saphenous veins

Three-year results of a randomized controlled trial comparing mechanochemical and thermal ablation in the treatment of insufficient great saphenous veins

Pain Outcomes Following Mechanochemical Ablation vs Cyanoacrylate Adhesive for the Treatment of Primary Truncal Saphenous Vein Incompetence

Interventions for great saphenous vein insufficiency: A systematic review and network meta-analysis

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