Mechanochemical Endovenous Ablation, Mechanochemical Ablation: A Novel Endo-venous Technique without Tumescent Anesthesia and Comparable Results for Treatment of Varicose Veins

Background: Minimally invasive endo-venous techniques have revolutionized the treatment and outcome of insufficient truncal veins and are associated with an good outcome. The use of thermal energy (EVLT- endo-venous laser therapy) requires the instillation of tumescent anesthesia around the vein. Mechanochemical endovenous ablation (MOCA) combines mechanical endothelial damage, using a rotating wire/ prongs, with simultaneous infusion of a liquid foam sclerosant. Studies using MOCA™ in both great and small saphenous veins showed good anatomical and clinical results with fast and equivalent post-operative outcome and recovery. Method(s): Mechanochemical endovenous ablation versus radiofrequency ablation in the treatment of primary great and small saphenous vein insufficiency is a single center study in which total of 30 patients (40 limbs) randomized (1:1) to MOCA™ and EVLT are studied. Patients with primary great and small saphenous vein varicosity and /or incompetence, are studied. The primary endpoint is anatomic success, defined as occlusion of the treated veins objectified with duplex ultrasonography at 3 months of follow-up. Post-procedural pain, initial technical success, clinical success, complications and the duration of the procedure and patient satisfaction were studied and compared. Both groups evaluated on an intention-to-treat principle. Result(s): The clinical (sign and symptoms) and radiological (on doppler ultrasound) outcome of both MOCA and EVLT are almost comparable. The peri-procedural pain is significantly less in the MOCA. There is no need of multiple needle injections to inject tumescent anesthesia in MOCA, so it is easy to perform MOCA. Patient satisfaction was better in MOCA. Varicosities associated and connected with GSV and SSV also got sclerosed through sclerosant injected into GSV and SSV. Conclusion(s): Significantly decreased peri-procedural pain and ease of the MOCA therapy in the treatment of varicose veins can make it treatment of choice in the treatment of varicose veins over EVLT as per our study.

 

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Artikel online veröffentlicht:
11. Mai 2021