title: Mechanochemical ablation for symptomatic great saphenous vein reflux: A two-year follow-up.
abstract: Background Several studies have shown comparable early efficacy of mechanochemical ablation to endothermal techniques. The goal of this report was to show if early efficacy is maintained at 24 months. Methods This was a two-year analysis on the efficacy of mechanochemical ablation in patients with symptomatic C2 or more advanced chronic venous disease. Patients with reflux in the great saphenous vein involving the sapheno-femoral junction and no previous venous interventions were included. Demographic information, clinical, and procedural data were collected. The occlusion rate of treated veins was assessed with duplex ultrasound. Patient clinical improvement was assessed by Clinical-Etiology-Anatomy-Pathophysiology (CEAP) class and venous clinical severity score. Results Of the initial 126 patients, there were 65 patients with 24 month follow-up. Of these 65 patients, 70% were female, with a mean age of 70 ± 14 years and an average body mass index (BMI) of BMI of 30.5 ± 6. The mean great saphenous vein diameter in the upper thigh was 7.6 mm and the mean treatment length was 39 cm. Adjunctive treatment of the varicosities was performed in 14% of patients during the procedure. Closure rates were 100% at one week, 98% at three months, 95% at 12 months, and 92% at 24 months. There was one patient with complete and four with partial recanalization ranging from 7 to 12 cm (mean length 9 cm). There was significant improvement in CEAP and venous clinical severity score (P < .001) for all time intervals. Conclusion Early high occlusion rate with mechanochemical ablation is associated with significant clinical improvement which is maintained at 24 months, making it a very good option for the treatment of great saphenous vein incompetence.
authors.affiliation: 1 Department of Surgery, Stony Brook University Medical Center, Stony Brook, USA.
authors.forename: Pamela S
authors.initials: PS
authors.lastname: Kim
authors.affiliation: 1 Department of Surgery, Stony Brook University Medical Center, Stony Brook, USA.
authors.forename: Muath
authors.initials: M
authors.lastname: Bishawi
authors.affiliation: 2 Vein Specialists of the Carolinas, Charlotte, USA.
authors.forename: David
authors.initials: D
authors.lastname: Draughn
authors.affiliation: 3 Modern Vein and Laser Center, Brooklyn, USA.
authors.forename: Marab
authors.initials: M
authors.lastname: Boter
authors.affiliation: 4 Richmond Vein Center, Richmond, USA.
authors.forename: Charles
authors.initials: C
authors.lastname: Gould
authors.affiliation: 5 Family Surgical and Vein Care, Battle Creek, USA.
authors.forename: John
authors.initials: J
authors.lastname: Koziarski
authors.affiliation: 6 Advanced Treatment Vein Center, Las Vegas, USA.
authors.forename: Rick
authors.initials: R
authors.lastname: Bernstein
authors.affiliation: 7 Hamilton Vein Center, Austin, USA.
authors.forename: Richard
authors.initials: R
authors.lastname: Hamilton
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D017115:Catheter Ablation; D005260:Female; D005268:Femoral Vein / Q000000981:diagnostic imaging / Q000601:surgery; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D012501:Saphenous Vein / Q000000981:diagnostic imaging / Q000601:surgery; D018616:Ultrasonography, Doppler, Duplex; D014648:Varicose Veins / Q000000981:diagnostic imaging / Q000601:surgery
keywords: Chronic venous disease; mechanochemical ablation; varicose veins