Mechanochemical ablation for great and small saphenous veins insufficiency in patients with type III shunt

Abstract

Objective the aim of this study was to assess the results of mechanochemical endovenous ablation either in the primary or recurrent saphenous vein insufficiency, including only patients with veno-venous shunt type III. Methods retrospective analysis of a prospective study of patients with symptomatic chronic venous insufficiency who underwent ClariVein® technique. A total of 134 saphenous veins were included between August 2017 and August 2018. Follow-up was performed by Duplex ultrasound at 1, 6 and 12 months. Primary endpoints were technical and anatomical success. Secondary endpoints were the need for further treatment of varicose collateral veins by sclerotherapy, outcomes regarding recurrent insufficiency and clinical success. Results A total of 111 great saphenous veins and 23 small saphenous veins were treated with a technical success of 95.6%. The overall anatomical success rates at 1, 6 and 12 month were 96.2%, 88.8% and 84.4%, respectively, without differences between primary and recurrent insufficiency. Deferred sclerotherapy over varicose collaterals was carried out in 28% of the patients with anatomical success. Clinical improvement was achieved in 87.3%. Conclusions MOCA technique has proven to be an effective technique, although additional treatment over varicose collaterals could be necessary in up to one-third. Atrophy of the saphenous vein and the lack of persistent varicose collateral veins during follow-up seem to be indicators of successful therapy.

Efficacy of Micronized Purified Flavonoid Fraction-Based Venoactive Therapy After Endovenous Mechanochemical Obliteration: Prospective Comparative Study

“…The tumescentless mechanochemical ablation (MOCA) technique has become an alternative treatment modality. Mechanochemical devices (ClariVein, Flebogrif) have been developed to minimize the negative aspects of both endothermal ablation and ultrasound-guided foam sclerotherapy for the treatment of saphenous incompetence, while incorporating the benefits of each [1][2][3][4][5][6]. Treatment with MOCA resulted in less postoperative pain/edema and a faster improvement in the Venous Clinical Severity Score (VCSS) in the short term but more hyperpigmentation compared with radiofrequency ablation (RFA) [7].…”