title: Mechanochemical Endovenous Occlusion of Varicose Veins Using the ClariVein® Device.
abstract: BACKGROUND
  In the last decade, minimally invasive endothermal ablation techniques have replaced surgery for the treatment of superficial venous insufficiency to reduce postoperative complications and recovery time and to improve quality of life. To avoid the risks of nerve damage and need for tumescent anesthesia to improve patient comfort, an alternative heatless technique has been introduced recently.
  
  
  METHODS
  Endovenous mechanochemical occlusion using the ClariVein® catheter (Vascular Insights LLC, Quincy, MA) is a new technique combining mechanical injury to the venous endothelium coupled with simultaneous catheter-guided infusion of a liquid sclerosant. This produces irreversible damage to the endothelium resulting in fibrosis of the vein.
  
  
  RESULTS
  The technique is related to a low complication rate and a success rate of 96% at two years and sustained quality of life improvement. This closure rate is comparable to endothermal techniques, but significantly less postoperative pain and earlier return to normal activities and work has been reported with endovenous mechanochemical occlusion.
  
  
  CONCLUSIONS
  Mechanochemical occlusion using ClariVein® has proven to be safe and effective and has several advantages compared to endothermal techniques. The possibility of retrograde ablation of distal SSV insufficiency in C6 ulceration is considered a significant advantage. Randomized comparative studies with long-term follow up will continue to define the definite place of mechanochemical occlusion.
authors.affiliation: Department of Surgery, Gelre Hospital, Apeldoorn, The Netherlands.
authors.forename: Marianne E
authors.initials: ME
authors.lastname: Witte
authors.affiliation: Department of Surgery, Rijnstate Hospital, Arnhem, The Netherlands.
authors.forename: Michel M P J
authors.initials: MM
authors.lastname: Reijnen
authors.affiliation: Department of Surgery, Antonius Hospital, Nieuwegein, The Netherlands.
authors.forename: Jean-Paul
authors.initials: JP
authors.lastname: de Vries
authors.affiliation: Department of Surgery, University Medical Center, University of Groningen, Groningen, The Netherlands.
authors.forename: Clark J
authors.initials: CJ
authors.lastname: Zeebregts
mesh_terms: D057510:Endovascular Procedures / Q000009:adverse effects / Q000295:instrumentation* / Q000379:methods; D004867:Equipment Design; D006801:Humans; D011183:Postoperative Complications; D011788:Quality of Life; D012597:Sclerosing Solutions / Q000008:administration & dosage / Q000627:therapeutic use; D015911:Sclerotherapy / Q000009:adverse effects / Q000295:instrumentation* / Q000379:methods; D012981:Sodium Tetradecyl Sulfate / Q000008:administration & dosage / Q000627:therapeutic use; D060205:Therapeutic Occlusion / Q000009:adverse effects / Q000295:instrumentation* / Q000379:methods; D016896:Treatment Outcome; D014648:Varicose Veins / Q000628:therapy*
chemical_list: D012597:Sclerosing Solutions; D012981:Sodium Tetradecyl Sulfate