Endovenous Mechanochemical Ablation of Great Saphenous Vein Incompetence Using the ClariVein Device: A Safety Study

Eekeren, Ramon R.J.P. van; Boersma, Doeke; Elias, Steven M.; Holewijn, Suzanne; Werson, Debora A.B.; Vries, J.P.P.M. de; Reijnen, Michel

doi:10.1583/11-3394.1

Cited by 94 publications

(85 citation statements)

References 20 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…MOCA requires constant ultrasound guidance. The ClariVein device (Vascular Insights, LLC, Quincy, MA, USA) is at the moment the most popular MOCA system [1,2]. Recently, the Flebogrif system (Balton, Warsaw, Poland) has also become commercially available [7].…”

Section: One-year Results Of Fifty Consecutive Patients Treated With mentioning

confidence: 99%

“…

…”

mentioning

confidence: 99%

See 1 more Smart Citation

One-year results of fifty consecutive patients treated with mechanochemical ablation of great and small saphenous vein

Stanišić¹,

Węgrzynowski²,

Pawlaczyk-Gabriel³

2015

View full text Add to dashboard Cite

102Mechanochemical ablation (MOCA) of the great saphenous vein (GSV) and small saphenous vein (SSV) is a relatively new method of treatment for superficial venous reflux [1][2][3]. This method is based on mechanical injury of the venous wall by rotating the tip of the catheter with subsequent injection of a sclerosant: polidocanol or sodium tetradecyl sulfate (STS). The method has been developed as an alternative to thermal ablation, such as endovenous laser ablation (EVLA), radiofrequency ablation or ablation with steam [4]. Recently, medical glues have provided a novel alternative to MOCA [5,6]. The rationale to introduce MOCA into medical practice is based on the potential risk of thermal injury of surrounding anatomic structures during EVLA or other methods of thermal ablation [4]. MOCA systems, which are cur- AbstrActObjectives: Mechanochemical ablation (MOCA) of the great saphenous vein (GSV) and the small saphenous vein (SSV) is an alternative to thermal ablation for the treatment of superficial venous reflux. The aim of this study was to assess the efficacy of MOCA for the treatment of incompetent GSV and SSV. Material and methods: We included 50 patients (60 legs) with incompetent GSV or SSV. Patients were aged 22-71 years, with median age of 41 years. Diameters of the saphenous veins treated were 4-16 mm, with median diameter 9 mm. Lengths of incompetent segments of the GSVs were 20-45 cm, with median length 36 cm. Lengths of incompetent segments of the SSVs were 12-25 cm, with median length 17 cm. We performed venous ablation using the ClariVein device with simultaneous injection of 2% polidocanol in the dose of 0.2 ml per cm of the treated vein. All patients completed 12 months follow-up. Results: In all patients the procedure resulted in complete occlusion of the incompetent segment of the saphenous vein. Additional foam sclerotherapy was needed in 41 legs (68.3%). After 12 months partial or complete recanalisation was revealed in one GSV and 3 SSVs. The remaining veins (93.3%) were completely occluded. During the procedure we observed transient signs of polidocanol toxicity in 2 patients. Conclusions: MOCA using the ClariVein device is a safe method for ablation of incompetent truncal veins in patients who prefer to be managed quickly, without pain and with satisfactory results after 1 year.

show abstract

Section: One-year Results Of Fifty Consecutive Patients Treated With mentioning

confidence: 99%

“…

…”

mentioning

confidence: 99%

One-year results of fifty consecutive patients treated with mechanochemical ablation of great and small saphenous vein

Stanišić¹,

Węgrzynowski²,

Pawlaczyk-Gabriel³

2015

View full text Add to dashboard Cite

show abstract

“…It should be emphasised that our team began the research on injuring the endothelium in addition to chemical ablation before the invention of the ClariVein system was released. Considering the good results of the ClariVein, our concept of mechanochemical ablation seems to be correct [5][6][7]. The mechanism of action of the Phlebogriffe has a solid pathophysiological basis [8][9][10].…”

Section: Discussionmentioning

confidence: 99%

Phlebogriffe – a new device for mechanochemical ablation of incompetent saphenous veins: a pilot study

Ciostek¹,

Kowalski²,

Woźniak³

et al. 2015

View full text Add to dashboard Cite

Objectives: The aim of this study was to evaluate the feasibility, safety and early results of mechanochemical ablation of incompetent varicose veins using a special catheter: the Phlebogriffe. Material and methods:The design of this catheter is based on a typical diagnostic catheter. Into this catheter a metal shank, attached to which are 5 thin, curved, springy wires with sharpened ends, is introduced. After being pushed out of the catheter, these wires deploy into a cat's claw pattern. When the whole device -the catheter and shank with open claws -is being pulled out, sclerosing foam is administered. In this pilot study, which was performed in the years 2011-2013, we evaluated 40 patients with varicose veins. Efficacy of the procedure, defined as closure of the treated vein, and clinical result evaluated using the Venous Clinical Severity Score (VCSS) were assessed after 1, 3, 6 and 12 months. Results: Efficacy of the procedure after 1, 3, 6 and 12 months was 97.4%, 94.9%, 89.7% and 89.7%, respectively. Statistical analysis of the VCSS before the procedure and after 12 months revealed statistically significant improvements regarding pain, presence of varicose veins, oedema, number and size of active ulcers, their duration, size of active ulcers and the use of compression therapy. The average improvement in VCSS scores was 3.56 points. Conclusions:The Phlebogriffe is a device that offers new opportunities for safe and efficient treatment of varicose veins associated with incompetence of saphenous veins.

show abstract

“…O esclerosante usado pode ser tanto o polidocanol como o sulfato de sódio tetradecil. O cateter é retirado a uma velocidade de aproximadamente 1-2 mm por segundo 19,20 .…”

Section: Método Mecânico-químicounclassified

Abordagens cirúrgicas no tratamento de varizes

Pereira

Mesquita

Gomes

2014

Angiologia e Cirurgia Vascular

View full text Add to dashboard Cite

Doença venosa crónica;Varizes; Cirurgia vascular; Stripping da veia grande safena; Técnicas minimamente invasivas Resumo A doença venosa crónica dos membros inferiores é uma patologia médica muito prevalente a nível global, sendo o refluxo da veia grande safena (VGS) a forma mais frequente de insuficiência. Acarreta um peso individual ao causar uma diminuição na qualidade de vida do doente e a nível social ao causar uma sobrecarga não desprezível nos orçamentos de saúde. Tradicionalmente a laqueação da junção safeno-femoral associada ao stripping da VGS foi a técnica gold standard no tratamento de varizes. No entanto, nos últimos anos, as técnicas minimamente invasivas têm ganho terreno sendo já consideradas alternativas seguras e eficazes ao método de stripping, mais tradicional.Foi feita uma pesquisa de artigos comparativos das várias técnicas no «Journal of Vascular Surgery», «European Journal of Vascular and Endovascular Surgery», «Phlebology: The Journal of Venous Disease», «Cochrane» e «PubMed».A revisão das técnicas foi feita com base num total de 12 artigos (estudos prospetivos, ensaios clínicos aleatorizados e não aleatorizados, estudos de coorte) com períodos de follow-up compreendidos entre as 16 semanas e os 5 anos.A curto e médio prazo as novas técnicas apresentam várias vantagens em relação ao stripping da VGS: menos dor, menor período de convalescença, melhores scores de qualidade de vida e maior satisfação do doente. No entanto, não foi possível afirmar uma superioridade das mesmas em relação ao método tradicional a longo prazo. São necessários mais estudos, com períodos de follow-up mais prolongados, com particular valor dos ensaios clínicos aleatorizados.Abstract Chronic venous disease of the lower limbs is a very common medical condition globally, with the reflux of the great saphenous vein being the most frequent form of insufficiency. * Autor para correspondência. Correio eletrónico: filipa.abelha.pereira@gmail.com (A.F. Abelha Pereira).

show abstract

Endovenous Mechanochemical Ablation of Great Saphenous Vein Incompetence Using the ClariVein Device: A Safety Study

Abstract: This study showed that endovenous MOCA, using polidocanol, is feasible and safe in the treatment of GSV incompetence. Larger studies with a prolonged follow-up are indicated to prove the efficacy of this technique in terms of obliteration rates.

Cited by 94 publications

References 20 publications

One-year results of fifty consecutive patients treated with mechanochemical ablation of great and small saphenous vein

One-year results of fifty consecutive patients treated with mechanochemical ablation of great and small saphenous vein

Phlebogriffe – a new device for mechanochemical ablation of incompetent saphenous veins: a pilot study

Abordagens cirúrgicas no tratamento de varizes

Contact Info

Product

Resources

About