Post ablation recanalization of varicose veins of the limbs: Comparison ablation method of mechanochemical and laser procedure

Abstract

Endovenous ablation has been performed for varicose veins of the limbs in Indonesia since 2010. Endovenous laser ablation (EVLA) therapy has been performed in Cipto Mangunkusumo Hospital (RSCM) in Jakarta, and mechanochemical ablation (MOCA) has been conducted in Fatmawati Hospital. This was a descriptive analytical study, with a cross-sectional design to analyze post-ablation recanalization after MOCA and EVLA procedures. Patients who had undergone MOCA or EVLA treatment were interviewed 3–18 months after the procedures. All the patients underwent vascular ultrasonography (USG) of the operated limb to assess recanalization. Secondary presurgery data were obtained from the patients’ from patients’ medical records. The clinical characteristics of the subjects were recorded to compare the potential correlation between these characteristics and recanalization post-MOCA and EVLA procedures. All the data were analyzed using SPSS ver. 20.0. The study consisted of 43 limbs: 24 treated by MOCA and 19 treated by EVLA. Most subjects in the MOCA group were <60 years (20/24), and 16 of the subjects were women. In the EVLA group, nine patients were <60 years, and 19 were ≥60 years, 15 of whom were women. The body mass index (BMI) of the majority (18/24) of the subjects in the MOCA group was normal, whereas most of the patients in the EVLA (10/19) group were overweight. In the MOCA group, the largest diameter of the vena saphena magna (VSM) in 20/24 extremities prior to treatment was VSM 4–7 mm, whereas the largest diameter in the EVLA group prior to treatment was >7 mm in 13/19 extremities. In the MOCA group, total recanalization occurred in 2/24 extremities, and partial recanalization occurred in 8/24 extremities. In the EVLA group, total recanalization occurred in 1/19 extremities, and partial recanalization occurred in 3/19 extremities. The association between the clinical characteristics of the patients and recanalization was not statistically significant (p > 0.05). The recanalization tendency was higher in the MOCA group than in the EVLA group. Although there was no statistically significant association between the clinical characteristics of the patients and recanalization, the largest diameter of the VSM presurgery (>7 mm) was higher in 3/4 extremities in the MOCA group, as compared to 3/13 extremities in the EVLA group.