Mechanochemical endovenous ablation for the treatment of great saphenous vein insufficiency.

Abstract

This study evaluated the feasibility, safety, and 1-year results of mechanochemical endovenous ablation (MOCA) of great saphenous vein (GSV) insufficiency. 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 1year 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 6weeks, 6months, and 1year after treatment. The technical success was 99%. The mean postprocedural pain during the first 14days after treatment was 7.5mm (interquartile range [IQR], 0.0-10.0mm) per day ona 0- to 100-mm visual analog scale. The time to return to normal activities and work was 1.0day (IQR, 0-1.0day) and 1.0day (IQR, 1.0-4.0days), 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) 1year after MOCA. At 1year, 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 theRAND 36-Item Health Survey scores improved significantly at 1-year follow-up. MOCA is a safe and effective technique in thetreatment of GSV insufficiency with good clinical and anatomic success at 1-year follow-up. The technique is relatedto low postprocedural pain scores, low complication rate, improved quality of life, and rapid resumption of normal activities and work.