Home > Journals > SCIREA Journal of Clinical Medicine > Archive > Paper Information

The feasibility of combined thermal and nonthermal endovenous ablation in comparison of nonthermal ablation for superficial vein insufficiency from single center

Volume 6, Issue 6, December 2021    |    PP. 462-473    |PDF (166 K)|    Pub. Date: October 10, 2021
9 Downloads     121 Views  

Author(s)
KJ Choi, Department of cardiovascular surgery, Khatlon state medical university, Tajikistan
HJ Jun, Department of vascular surgery, Jun’s vascular clinic, Busan, Republic of Korea
Myunghee Yoon, Department of Surgery, Pusan National University Hospital, Republic of Korea

Abstract
Background: Nonthermal endovenous ablation has been needed high amount of sclerosant for the treatment of saphenous vein insufficiency. However, its safe amount has not been known clearly and nonthermal edovenous ablation should be performed avoiding thrombotic complication. This study is to evaluate the feasibility of the combined nonthermal and thermal endovenous ablation technique to reduce the amount of sclerosant in comparison of nonthermal endovenous ablation monotherapy.
Methods: Between June 2018 and May 2020, a total of 327 patients diagnosed with superficial vein insufficiency were evaluated retrospectively. 130 patients were includedin Nonthermal mechanochemical ablation (MOCA, Group I) monotherapy, 197 patients in combined thermal and nonthermal endovenous ablation treatment (EVLA with MOCA, Group II) from one surgeon of single center. Combined EVLA and MOCA therapy was mostly performed for patients who had varicose veins in 3 or more veins.
Results: The amount of STD used per number of legs was 5.5±2.05 mL, 4.51±1.2 mL in Group I, Group II respectively (p<0.001). The amount of STD used per numberof veins was 4.77±1.91 mL, 3.12±1.02 mL in Group I, Group II respectively (p<0.001). Recanalization rates were 0% (0/130) within 52 weeks, 2.31% (3/130) after 52 weeks in Group I, 5.58% (11/197) within 52 weeks, 6.60% (13/197) after 52 weeks inGroup II, it was not statistically significant. Complications within 4 weeks Complicationrates were 3.84%, 7.11% in Group I, Group II respectively
Conclusions: Combined EVLA and MOCA procedure was effective for those who had3 or more varicose veins insufficiency. The varicose vein anatomical occlusion at 1 year, patient satisfaction and complication rates were included.

Keywords
Chronic venous insufficiency, Thermal endovenous laser ablation, non-thermal mechanochemical ablation, sclerosant, occlusion

Cite this paper
KJ Choi, HJ Jun, Myunghee Yoon, The feasibility of combined thermal and nonthermal endovenous ablation in comparison of nonthermal ablation for superficial vein insufficiency from single center, SCIREA Journal of Clinical Medicine. Vol. 6 , No. 6 , 2021 , pp. 462 - 473 .

References

[ 1 ] Julie Brittenden, David Cooper, Maria Dimitrova, Graham Scotland, Seonaidh C. Cotton, et al. Five-Year Outcomes of a Randomized Trial of Treatments for Varicose Veins. N Engl J Med 2019; 381, 912-22
[ 2 ] L. H. Rasmussen, M. Lawaetz, L. Bjoern, B. Vennits, A. Blemings et al. Randomized clinical trial comparing endovenous laser ablation, radiofrequency ablation, foam sclerotherapy and surgical stripping for great saphenous varicose veins. British J of Surg 2011, 98, 1079-1087
[ 3 ] Eklof B, Rutherford RB, Bergan JJ, Carpentier PH, Gloviczki P, Kistner RL et al. Revision of the CEAP classification for chronic venous disorders: consensus statement. J Vasc Surg 2004, 40, 1248–1252.
[ 4 ] Elias S and Raines JK. Mechanochemical tumescentless endovenous ablation: final results of the initial clinical trial. Phlebology 2012; 27: 67–72.
[ 5 ] Y L Lam, Irwin M Toonder, Cees H A Wittens. Clarivein® mechano-chemical ablation an interim analysis of a randomized controlled trial dose-finding study Randomized Controlled Trial Phlebology 2016, 31(3), 170-176
[ 6 ] Justyna Wilczko, Cezary Szary, Dominika Plucinska and Tomasz Grzela. Two-Year Follow-Up after Endovenous Closure with Short-Chain Cyanoacrylate versus Laser Ablation in Venous Insufficiency. J Clin Med. 2021, 10, 628
[ 7 ] TY Tang, JW Kam and ME Gaunt. ClariVein® – Early results from a large single-centre series of mechanochemical endovenous ablation for varicose veins. Phlebology 2017, 32(1), 6–12
[ 8 ] Abduraheem Hussein Mohamed, Y Clement Leung, Tom Wallace, George Smith, Daniel Carradice, and Ian Chetter. A Randomized Controlled Trial of Endovenous Laser Ablation Versus Mechanochemical Ablation With ClariVein in the Management of Superficial Venous Incompetence (LAMA Trial). Annals of Surgery 2021, 273, e188-e195
[ 9 ] Clement C. M. Leung, Daniel Carradice, Tom Wallace and Ian C. Chetter. Endovenous laser ablation versus mechanochemical ablation with ClariVein® in the management of superficial venous insufficiency (LAMA trial): study protocol for a randomised controlled trial. Trials 2016, 17, 421
[ 10 ] Julie Brittenden, David Cooper, Maria Dimitrova, Graham Scotland, Seonaidh C. Cotton. Five-Year Outcomes of a Randomized Trial of Treatments for Varicose Veins. N Engl J Med 2019, 381, 912-922
[ 11 ] Sichlau MJ and Ryu RK. Cutaneous thermal injury after endovenous laser ablation of the great saphenous vein. J Vasc Interv Radiol 2004, 15, 865–867.
[ 12 ] Van Den Bos RR, Neumann M, De Roos KP, et al. Endovenous laser ablation-induced complications: review of the literature and new cases. Dermatol Surg 2009, 35, 1206–1214.
[ 13 ] Elias S and Raines JK. Mechanochemical tumescentless endovenous ablation: final results of the initial clinical trial. Phlebology 2012, 27, 67–72.
[ 14 ] van Eekeren RR, Boersma D, Elias S, et al. Endovenous mechanochemical ablation of great saphenous vein incompetence using the ClariVein device: a safety study. J Endovasc Ther 2011, 18, 328–334.
[ 15 ] Boersma D, van Eekeren RR, Werson DA, et al. Mechanochemical endovenous ablation of small saphenous vein insufficiency using the ClariVein device: one-year results of a prospective series. Eur J Vasc Endovasc Surg 2013, 45, 299–303.
[ 16 ] Deijen CL, Schreve MA, Bosma J, et al. Clarivein mechanochemical ablation of the great and small saphenous vein: early treatment outcomes of two hospitals. Phlebology 2016, 31, 192–197.
[ 17 ] Vun S, Rashid S, Blest N and Spark J. Lower pain and faster treatment with mechanico-chemical endovenous ablation using ClariVein. Phlebology 2014, 30, 688–692.
[ 18 ] Bootun R, Lane T, Dharmarajah B, et al. Intra-procedural pain score in a randomised controlled trial comparing mechanochemical ablation to radiofrequency ablation: the multicentre venefit versus ClariVein for varicose veins trial. Phlebology 2014, 31, 61-65
[ 19 ] Yong Wonn Kwon, Sang Woo Park, Jin Ho Hwang, Hyemin Jang, Jeeyoung Min, et al. Feasibility and short-term complication rate of mechanochemical ablation for epifascial tributaries of incompetent great saphenous veins. J Vasc Surg Venous Lymphat Disord 2021, 9(4), 925-931