A multi-centre randomised controlled trial comparing radiofrequency and mechanical occlusion chemically assisted ablation of varicose veins – Final results of the Venefit versus Clarivein for varicose veins trial

Lane, Tristan; Bootun, Roshan; Dharmarajah, Brahman; Lim, Chung Sim; Najem, Mojahid; Renton, Sophie; Sritharan, Kaji; Davies, Alun H.

doi:10.1177/0268355516651026

Cited by 94 publications

(70 citation statements)

References 25 publications

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“…A total of 28% of patients presented with small hematomas, 17% had local skin hardening, and 18% felt discomfort for more than a week after the procedure. High effectiveness of this method over follow-up periods ranging from 6 to 24 months has been confirmed in several other studies [15][16][17][18][19][20].…”

Section: Discussionmentioning

confidence: 59%

Application of endovenous mechanochemical ablation (MOCA) with Flebogrif™ to treat varicose veins of the lower extremities: a single center experience over 3 months of observation

Zubilewicz

Terlecki

et al. 2017

Acta Angiologica

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Section: Discussionmentioning

confidence: 59%

Application of endovenous mechanochemical ablation (MOCA) with Flebogrif™ to treat varicose veins of the lower extremities: a single center experience over 3 months of observation

Zubilewicz

Terlecki

et al. 2017

Acta Angiologica

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“…Adverse effects reported were 1 DVT in each group. 48 Another prospective multicenter RCT (MARADONA trial) is due to report soon, comparing MOCA with RFA in the treatment of GSV incompetence. This trial is intended to examine the anatomical, clinical success and post-procedural pain between MOCA and RFA at 1 year in 460 patients with follow-up for 5 years.…”

Section: Mechanochemical Endovenous Ablation (Moca)mentioning

confidence: 99%

Endovenous Management of Varicose Veins

et al. 2018

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Abstract:Varicose veins are a very common condition and have been the subject of a recent proliferation of treatment modalities. The advent of the endovenous treatment era has led to a confusing array of different techniques which can be daunting when making the transition from traditional surgery. All modalities offer excellent results in the right situation and each has their own treatment profile. Thermal ablation techniques have matured and have a reassuring and reliable outcome, but the arrival of non-thermal techniques has delivered further options for both patient and surgeon. This article provides an overview of the different treatment devices and modalities available to the modern superficial vein surgeon and details the currently available evidence and summation analysis to help surgeons to make an appropriate treatment choice for their patients. Keywords:Endovenous ablation, varicose veins, venous disease, radiofrequency, sclerotherapy, cyanoacrylate Page 1 of 24 http://mc.manuscriptcentral.com/ang Angiology 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 29 30 31 32 33 34 35 36 37 38 39 40 41 42 43 44 45 46 47 48 49 50 51 52 53 54 55 56 57 58 59 IntroductionVaricose veins are a common condition affecting up to one-third of the population, with detrimental effects on the quality of life (QoL). 1-2Until the past decade, the traditional technique of saphenofemoral or saphenopopliteal ligation with or without vein stripping has been the gold standard treatment of truncal saphenous incompetence. This usually necessitates either general or regional anaesthesia. 3 Although surgery provides good outcomes, it is associated with ecchymosis, hematoma, tenderness, 4 infection, nerve injury, delayed return to normal activity 3-5 and routinely necessitates narcotic analgesia. 3In response to the need for less invasive treatment, endovenous treatments, namely radio-frequency ablation (RFA) and endovenous laser ablation (EVLA) have been developed. These have led to a reduction in morbidity compared with open surgery, 4-6 by reducing postoperative pain, providing faster recovery time, improving QoL and lowering complication rates. 7-8More recently, new non-thermal, non-tumescent (NTNTs) treatments have been developed to overcome the shortcomings associated with thermal ablation. Both thermal and non-thermal treatments are discussed in this review. Thermal-Tumescent Ablative ManagementSince 1999, endovenous thermal ablation, in the form of RFA and EVLA have been developed. More recently, endovenous microwave ablation (EMA) and steam vein sclerosis (SVS) have also been introduced. Their mechanism of action involves using heat to cause thermal damage to the venous wall. Radio-frequency ablation (RFA)The practice of RFA utilizes radio-frequency waves to produce thermal energy (85-120°C) resulting in endothelial damage and sealing of the incompetent vein ( Figure 1). In 1999, the U.S. Food and Drug Administration (FDA) approved RFA for...

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“…The procedure is reportedly less painful than radiofrequency ablation 11,17,18 and, so, is often better tolerated than tumescent injections. However, the patient should always be warned of the unusual nature of the sensation produced by the device (the authors liken it to an electric toothbrush) as when the first segment is treated without warning, patients may flinch or move, displacing the catheter tip.…”

Section: Patient Selection General Considerationsmentioning

confidence: 99%

“…However, these techniques require the use of tumescent anaesthesia prior to energy delivery, which can be a source of discomfort for the patient and prolongs procedure time. 11 More recently, nonthermal, nontumescent (NTNTs) techniques have been developed to minimise these negative aspects associated with ETA. Mechanochemical ablation (MOCA) is one such method, with the brand name of ClariVein ® (Merit Medical, Utah, USA) ( Figure 1).…”

Section: Introductionmentioning

confidence: 99%

<p>ClariVein<sup>®</sup>, mechanochemical endovenous ablation: patient selection and perspective</p>

Belramman¹,

Bootun²,

Onida³

et al. 2019

JVD

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The American Venous Forum and the National Institute for Health and Care Excellence recommend endothermal ablation (ETA) techniques as the first line treatment for superficial venous incompetence. However, these techniques require the use of tumescent anaesthesia prior to energy delivery, which may be a source of discomfort for the patient and can prolong procedure time. Recently, nonthermal, nontumescent (NTNTs) techniques such as mechanochemical ablation (MOCA) have been developed to address some of the negative aspects associated with ETA. This article reviews this technique from a patient selection and perspective point view.

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A multi-centre randomised controlled trial comparing radiofrequency and mechanical occlusion chemically assisted ablation of varicose veins – Final results of the Venefit versus Clarivein for varicose veins trial

Cited by 94 publications

References 25 publications

Application of endovenous mechanochemical ablation (MOCA) with Flebogrif™ to treat varicose veins of the lower extremities: a single center experience over 3 months of observation

Application of endovenous mechanochemical ablation (MOCA) with Flebogrif™ to treat varicose veins of the lower extremities: a single center experience over 3 months of observation

Endovenous Management of Varicose Veins

<p>ClariVein<sup>®</sup>, mechanochemical endovenous ablation: patient selection and perspective</p>

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