title: Histological observations one year after mechanochemical endovenous ablation of the great saphenous vein.
abstract: OBJECTIVE
  To report histological analysis of a great saphenous vein (GSV) 1 year after undergoing mechanochemical endovenous ablation (MOCA) and compare the findings with those of a healthy vein.
  
  
  METHODS
  A 59-year-old patient with bilateral GSV incompetence was treated with MOCA using the ClariVein catheter, which has a dispersion wire that rotates as liquid sclerosant is injected in the vein. After 1 year, the patient had recurrent edema of the right leg; duplex ultrasound was suspicious for recanalization. The patient was reoperated, and the deep femoral vein was explored. The GSV was completely obliterated, and its proximal part was excised and sent for histological processing. Microscopic evaluation of the MOCA-treated vein showed a circumferential disappearance of the endothelial layer and fibrosis of the vein. The media was considerably damaged, with changes in collagen structure, supporting the therapeutic effect of MOCA.
  
  
  CONCLUSIONS
  MOCA is a novel endovenous treatment modality for saphenous vein insufficiency. Results of MOCA on the cellular level are essential to optimize treatment.
authors.affiliation: 1 Department of Surgery, Rijnstate Hospital, Arnhem, The Netherlands.
authors.forename: Ramon R J P
authors.initials: RR
authors.lastname: van Eekeren
authors.forename: Jan Luuk
authors.initials: JL
authors.lastname: Hillebrands
authors.forename: Kim
authors.initials: K
authors.lastname: van der Sloot
authors.forename: Jean-Paul P M
authors.initials: JP
authors.lastname: de Vries
authors.forename: Clark J
authors.initials: CJ
authors.lastname: Zeebregts
authors.forename: Michel M P J
authors.initials: MM
authors.lastname: Reijnen
mesh_terms: D055011:Ablation Techniques; D005260:Female; D006801:Humans; D008875:Middle Aged; D012008:Recurrence; D012501:Saphenous Vein / Q000473:pathology*; D012597:Sclerosing Solutions / Q000008:administration & dosage*; D015911:Sclerotherapy; D013997:Time Factors; D016896:Treatment Outcome; D014648:Varicose Veins / Q000175:diagnosis / Q000628:therapy*; D014689:Venous Insufficiency / Q000175:diagnosis / Q000628:therapy*
chemical_list: D012597:Sclerosing Solutions
keywords: ClariVein; endothelium; fibrosis; great saphenous vein; histological analysis; mechanochemical endovenous ablation; sclerosant; varicose vein; venous insufficiency