title: Glue, steam and Clarivein--Best practice techniques and evidence.
abstract: In July 2013, the National Institute of Health and Clinical Excellence (NICE) recommended "endothermal" ablation (meaning endovenous thermal ablation) is the first line treatment for truncal venous reflux in varicose veins. The initial endovenous thermoablation devices were radiofrequency ablation and endovenous laser ablation. More recently, Glue (cyanoacrylate), endovenous steam and Clarivein (mechanochemical ablation or MOCA) have entered the market as new endovenous techniques for the treatment of varicose veins. Glue and Clarivein do not require tumescent anaesthesia and do not use heat and therefore termed non-tumescent non-thermal (NTNT). Steam both requires tumescence and is also a thermal technique (TT). This article reviews the current position of these 3 new technologies in the treatment of varicose veins.
authors.affiliation: The Whiteley Clinic, Guildford and London, UK mark@thewhiteleyclinic.co.uk.
authors.forename: Mark S
authors.initials: MS
authors.lastname: Whiteley
mesh_terms: D000269:Adhesives / Q000737:chemistry; D000758:Anesthesia; D017115:Catheter Ablation / Q000379:methods; D003487:Cyanoacrylates / Q000737:chemistry*; D057510:Endovascular Procedures / Q000379:methods*; D006801:Humans; D053685:Laser Therapy; D012501:Saphenous Vein / Q000601:surgery; D012597:Sclerosing Solutions / Q000737:chemistry; D015911:Sclerotherapy / Q000295:instrumentation; D013227:Steam; D013314:Stress, Mechanical; D014648:Varicose Veins / Q000628:therapy*
chemical_list: D000269:Adhesives; D003487:Cyanoacrylates; D012597:Sclerosing Solutions; D013227:Steam
keywords: MOCA; Varicose veins; clarivein; cyanoacrylate; endovenous; glue; mechanicochemical ablation; steam vein sclerosis; superficial venous reflux; thermoablation