Mechanochemical endovenous ablation for the treatment of great saphenous vein insufficiency

Ramon R J P van Eekeren; Doeke Boersma; Suzanne Holewijn; Debora A B Werson; Jean Paul P M de Vries; Michel M J P Reijnen

doi:10.1016/j.jvsv.2014.01.001

Mechanochemical endovenous ablation for the treatment of great saphenous vein insufficiency

J Vasc Surg Venous Lymphat Disord. 2014 Jul;2(3):282-8. doi: 10.1016/j.jvsv.2014.01.001. Epub 2014 Mar 14.

Authors

Ramon R J P van Eekeren¹, Doeke Boersma², Suzanne Holewijn³, Debora A B Werson², Jean Paul P M de Vries², Michel M J P Reijnen³

Affiliations

¹ Department of Surgery, Rijnstate Hospital, Arnhem, The Netherlands. Electronic address: rvaneekeren@rijnstate.nl.
² Department of Vascular Surgery, St. Antonius Hospital, Nieuwegein, The Netherlands.
³ Department of Surgery, Rijnstate Hospital, Arnhem, The Netherlands.

PMID: 26993387
DOI: 10.1016/j.jvsv.2014.01.001

Abstract

Objective: This study evaluated the feasibility, safety, and 1-year results of mechanochemical endovenous ablation (MOCA) of great saphenous vein (GSV) insufficiency.

Methods: A consecutive 106 patients were treated for primary GSV insufficiency with MOCA by the ClariVein device and polidocanol. The primary outcome measures were technical success, clinical success, and anatomic success after 1 year of follow-up. Secondary outcome measures were postprocedural pain, complications, general- and disease-specific quality of life, and time to return to work. Patients were evaluated with clinical examination and duplex ultrasonography at 6 weeks, 6 months, and 1 year after treatment.

Results: The technical success was 99%. The mean postprocedural pain during the first 14 days after treatment was 7.5 mm (interquartile range [IQR], 0.0-10.0 mm) per day on a 0- to 100-mm visual analog scale. The time to return to normal activities and work was 1.0 day (IQR, 0-1.0 day) and 1.0 day (IQR, 1.0-4.0 days), respectively. No major complications were recorded. At 1-year follow-up, the clinical success was 93%. The Venous Clinical Severity Score decreased significantly from 4.0 (IQR, 3.0-5.0) before treatment to 1.0 (IQR, 0-1.0) (P < .001) 1 year after MOCA. At 1 year, 88.2% of the treated GSVs remained occluded as measured by duplex ultrasonography. Twelve patients had a recanalization, of which eight were partial. Disease-specific quality of life and the RAND 36-Item Health Survey scores improved significantly at 1-year follow-up.

Conclusions: MOCA is a safe and effective technique in the treatment of GSV insufficiency with good clinical and anatomic success at 1-year follow-up. The technique is related to low postprocedural pain scores, low complication rate, improved quality of life, and rapid resumption of normal activities and work.