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Mechanochemical ablation

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https://www.readbyqxmd.com/read/27742900/midterm-outcome-of-mechanochemical-endovenous-ablation-for-the-treatment-of-great-saphenous-vein-insufficiency
#1
Marianne E Witte, Suzanne Holewijn, Ramon R van Eekeren, Jean-Paul de Vries, Clark J Zeebregts, Michel M P J Reijnen
PURPOSE: To report the midterm results of mechanochemical ablation (MOCA) for treating great saphenous vein (GSV) insufficiency. METHODS: In a 1-year period, 85 consecutive patients (median age 51.4 years; 71 women) undergoing MOCA with polidocanol in 104 limbs were enrolled in a prospective registry. The patients were evaluated at baseline and during follow-up (4 weeks and 1, 2, and 3 years) using duplex ultrasound, the CEAP (clinical, etiologic, anatomic and pathophysiologic) classification, the Venous Clinical Severity Score (VCSS), the RAND Short Form 36-Item Health Survey (RAND-SF36), and the Aberdeen Varicose Vein Questionnaire (AVVQ)...
October 14, 2016: Journal of Endovascular Therapy
https://www.readbyqxmd.com/read/27552990/endovenous-laser-ablation-versus-mechanochemical-ablation-with-clarivein-%C3%A2-in-the-management-of-superficial-venous-insufficiency-lama-trial-study-protocol-for-a-randomised-controlled-trial
#2
Clement C M Leung, Daniel Carradice, Tom Wallace, Ian C Chetter
BACKGROUND: Endovenous thermal techniques, such as endovenous laser ablation (EVLA), are the recommended treatment for truncal varicose veins. However, a disadvantage of thermal techniques is that it requires the administration of tumescent anaesthesia, which can be uncomfortable. Non-thermal, non-tumescent techniques, such as mechanochemical ablation (MOCA) have potential benefits. MOCA combines physical damage to endothelium using a rotating wire, with the infusion of a liquid sclerosant...
2016: Trials
https://www.readbyqxmd.com/read/27511882/comparison-of-microbubble-presence-in-the-right-heart-during-mechanochemical-and-radiofrequency-ablation-for-varicose-veins
#3
K H Moon, B Dharmarajah, R Bootun, C S Lim, Tra Lane, H M Moore, K Sritharan, A H Davies
OBJECTIVE: Mechanochemical ablation is a novel technique for ablation of varicose veins utilising a rotating catheter and liquid sclerosant. Mechanochemical ablation and radiofrequency ablation have no reported neurological side-effect but the rotating mechanism of mechanochemical ablation may produce microbubbles. Air emboli have been implicated as a cause of cerebrovascular events during ultrasound-guided foam sclerotherapy and microbubbles in the heart during ultrasound-guided foam sclerotherapy have been demonstrated...
August 10, 2016: Phlebology
https://www.readbyqxmd.com/read/26908872/phosphorylation-and-calcium-antagonistically-tune-myosin-binding-protein-c-s-structure-and-function
#4
Michael J Previs, Ji Young Mun, Arthur J Michalek, Samantha Beck Previs, James Gulick, Jeffrey Robbins, David M Warshaw, Roger Craig
During each heartbeat, cardiac contractility results from calcium-activated sliding of actin thin filaments toward the centers of myosin thick filaments to shorten cellular length. Cardiac myosin-binding protein C (cMyBP-C) is a component of the thick filament that appears to tune these mechanochemical interactions by its N-terminal domains transiently interacting with actin and/or the myosin S2 domain, sensitizing thin filaments to calcium and governing maximal sliding velocity. Both functional mechanisms are potentially further tunable by phosphorylation of an intrinsically disordered, extensible region of cMyBP-C's N terminus, the M-domain...
March 22, 2016: Proceedings of the National Academy of Sciences of the United States of America
https://www.readbyqxmd.com/read/26908638/clarivein%C3%A2-early-results-from-a-large-single-centre-series-of-mechanochemical-endovenous-ablation-for-varicose-veins
#5
T Y Tang, J W Kam, M E Gaunt
OBJECTIVES: This study assessed the effectiveness and patient experience of the ClariVein® endovenous occlusion catheter for varicose veins from a large single-centre series in the UK. METHODS: A total of 300 patients (371 legs) underwent ClariVein® treatment for their varicose veins; 184 for great saphenous vein (GSV) incompetence, 62 bilateral GSV, 23 short saphenous vein (SSV), 6 bilateral SSV and 25 combined unilateral great saphenous vein and SSV. Patients were reviewed at an interval of two months post procedure and underwent Duplex ultrasound assessment...
February 22, 2016: Phlebology
https://www.readbyqxmd.com/read/26811425/mechanochemical-ablation-for-symptomatic-great-saphenous-vein-reflux-a-two-year-follow-up
#6
Pamela S Kim, Muath Bishawi, David Draughn, Marab Boter, Charles Gould, John Koziarski, Rick Bernstein, Richard Hamilton
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...
January 24, 2016: Phlebology
https://www.readbyqxmd.com/read/26564912/treatment-modalities-for-small-saphenous-vein-insufficiency-systematic-review-and-meta-analysis
#7
REVIEW
Doeke Boersma, Verena N N Kornmann, Ramon R J P van Eekeren, Ellen Tromp, Çagdas Ünlü, Michel M J P Reijnen, Jean-Paul P M de Vries
PURPOSE: To investigate and compare the anatomical success rates and complications of the treatment modalities for small saphenous vein (SSV) incompetence. METHODS: A systematic literature search was performed in PubMed, EMBASE, and the Cochrane Library on the following therapies for incompetence of SSVs: surgery, endovenous laser ablation (EVLA), radiofrequency ablation (RFA), ultrasound-guided foam sclerotherapy (UGFS), steam ablation, and mechanochemical endovenous ablation (MOCA)...
February 2016: Journal of Endovascular Therapy
https://www.readbyqxmd.com/read/26556699/glue-steam-and-clarivein-best-practice-techniques-and-evidence
#8
REVIEW
Mark S Whiteley
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...
November 2015: Phlebology
https://www.readbyqxmd.com/read/26307590/clarivein-mechanochemical-ablation-of-the-great-and-small-saphenous-vein-early-treatment-outcomes-of-two-hospitals
#9
Charlotte L Deijen, Michiel A Schreve, Jan Bosma, A Jorianne de Nie, Vanessa J Leijdekkers, Peter J van den Akker, Anco Vahl
OBJECTIVES: Mechanochemical endovenous ablation is a novel technique for the treatment of great saphenous vein and small saphenous vein incompetence which combines mechanical injury of the endothelium with simultaneous infusion of liquid sclerosant. The main objective of this study was to evaluate early occlusion. METHODS: All consecutive patients who were eligible for the treatment with mechanochemical endovenous ablation were included. Inclusion period was from the introduction of the device in the hospitals (September 2011 and December 2011) until December 2012...
April 2016: Phlebology
https://www.readbyqxmd.com/read/26130051/the-advent-of-non-thermal-non-tumescent-techniques-for-treatment-of-varicose-veins
#10
REVIEW
Roshan Bootun, Tristan R A Lane, Alun H Davies
Varicose veins are common and their management has undergone a number of changes over the years. Surgery has been the traditional treatment option, but towards the 21st century, new endovenous thermal ablation techniques, namely, radiofrequency ablation and endovenous laser ablation, were introduced which have revolutionised the way varicose veins are treated. These minimally invasive techniques are associated with earlier return to normal activity and less pain, as well as enabling procedures to be carried out as day cases...
February 2016: Phlebology
https://www.readbyqxmd.com/read/26055013/mechanochemical-endovenous-occlusion-of-varicose-veins-using-the-clarivein%C3%A2-device
#11
REVIEW
Marianne E Witte, Michel M P J Reijnen, Jean-Paul de Vries, Clark J Zeebregts
INTRODUCTION: 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...
May 2015: Surgical Technology International
https://www.readbyqxmd.com/read/25723675/retrograde-inversion-stripping-as-a-complication-of-the-clarivein-mechanochemical-venous-ablation-procedure
#12
T R A Lane, H M Moore, I J Franklin, A H Davies
The endovenous revolution has accelerated the development of new techniques and devices for the treatment of varicose veins. The ClariVein mechanochemical ablation device offers tumescentless treatment with a rotating ablation tip that can theoretically become stuck in tissue. We present the first report of retrograde stripping of the small saphenous vein without anaesthesia following attempted use of the ClariVein device, without adverse sequelae.
March 2015: Annals of the Royal College of Surgeons of England
https://www.readbyqxmd.com/read/25354769/mechanochemical-endovenous-ablation-versus-radiofrequency-ablation-in-the-treatment-of-primary-small-saphenous-vein-insufficiency-messi-trial-study-protocol-for-a-randomized-controlled-trial
#13
RANDOMIZED CONTROLLED TRIAL
Doeke Boersma, Ramon R J P van Eekeren, Hans J C Kelder, Debora A B Werson, Suzanne Holewijn, Michiel A Schreve, Michel M P J Reijnen, Jean Paul P M de Vries
BACKGROUND: Minimally invasive endothermal techniques, for example, radiofrequency ablation (RFA), have revolutionized the treatment of insufficient truncal veins and are associated with an excellent outcome. The use of thermal energy requires the instillation of tumescent anesthesia around the vein. Mechanochemical endovenous ablation (MOCA™) combines mechanical endothelial damage, using a rotating wire, with simultaneous infusion of a liquid sclerosans. Tumescent anesthesia is not required as no heat is used...
2014: Trials
https://www.readbyqxmd.com/read/25300311/lower-pain-and-faster-treatment-with-mechanico-chemical-endovenous-ablation-using-clarivein%C3%A2
#14
COMPARATIVE STUDY
S V Vun, S T Rashid, N C Blest, J I Spark
OBJECTIVES: To assess the efficacy of the ClariVein(®) system of mechanico-chemical ablation of superficial vein incompetence. METHOD: ClariVein(®) treatment uses a micropuncture technique and a 4-Fr sheath to allow a catheter to be placed 1.5 cm from the saphenofemoral junction. Unlike laser (endovenous laser treatment (EVLT)) or radiofrequency ablation (RFA), no tumescence is required. The technique depends on a wire rotating at 3500 r/min causing endothelial damage whilst liquid sclerosant (1...
December 2015: Phlebology
https://www.readbyqxmd.com/read/25193822/intra-procedural-pain-score-in-a-randomised-controlled-trial-comparing-mechanochemical-ablation-to-radiofrequency-ablation-the-multicentre-venefit%C3%A2-versus-clarivein%C3%A2-for-varicose-veins-trial
#15
RANDOMIZED CONTROLLED TRIAL
R Bootun, T R A Lane, B Dharmarajah, C S Lim, M Najem, S Renton, K Sritharan, A H Davies
OBJECTIVE: Endovenous techniques are, at present, the recommended choice for truncal vein treatment. However, the thermal techniques require tumescent anaesthesia, which can be uncomfortable during administration. Non-tumescent, non-thermal techniques would, therefore, have potential benefits. This randomised controlled trial is being carried out to compare the degree of pain that patients experience while receiving mechanochemical ablation or radiofrequency ablation. The early results of this randomised controlled trial are reported here...
February 2016: Phlebology
https://www.readbyqxmd.com/read/25107833/what-next-after-thermal-ablation-for-varicose-veins-non-thermal-ablation
#16
S M McHugh, A L Leahy
BACKGROUND: Endothermal treatment of the great saphenous vein has become the first line of treatment for superficial venous reflux. Newer treatments, especially non-thermal ablation have potential benefits both for patient acceptability and decreased risk of nerve injury. APPROACH: We describe the current non-thermal options available including advantages and disadvantages. Ultrasound guided foam sclerotherapy avoids the risk of nerve injury, however it is not as effective as endothermal ablation...
October 2014: Surgeon: Journal of the Royal Colleges of Surgeons of Edinburgh and Ireland
https://www.readbyqxmd.com/read/24915593/histological-observations-one-year-after-mechanochemical-endovenous-ablation-of-the-great-saphenous-vein
#17
Ramon R J P van Eekeren, Jan Luuk Hillebrands, Kim van der Sloot, Jean-Paul P M de Vries, Clark J Zeebregts, Michel M P J Reijnen
PURPOSE: 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. CASE REPORT: 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...
June 2014: Journal of Endovascular Therapy
https://www.readbyqxmd.com/read/24726004/mechanochemical-endovenous-ablation-versus-radiofrequency-ablation-in-the-treatment-of-primary-great-saphenous-vein-incompetence-maradona-study-protocol-for-a-randomized-controlled-trial
#18
RANDOMIZED CONTROLLED TRIAL
Ramon R J P van Eekeren, Doeke Boersma, Suzanne Holewijn, Anco Vahl, Jean Paul p m de Vries, Clark J Zeebregts, Michel M P J Reijnen
BACKGROUND: Radiofrequency ablation (RFA) is associated with an excellent outcome in the treatment of great saphenous vein (GSV) incompetence. The use of thermal energy as a treatment source requires the instillation of tumescence anesthesia. Mechanochemical endovenous ablation (MOCA) combines mechanical endothelial damage, using a rotating wire, with the infusion of a liquid sclerosant. Tumescence anesthesia is not required. Preliminary experiences with MOCA showed good results and low post-procedural pain...
2014: Trials
https://www.readbyqxmd.com/read/24449904/comprehensive-structural-model-of-the-mechanochemical-cycle-of-a-mitotic-motor-highlights-molecular-adaptations-in-the-kinesin-family
#19
Adeline Goulet, Jennifer Major, Yonggun Jun, Steven P Gross, Steven S Rosenfeld, Carolyn A Moores
Kinesins are responsible for a wide variety of microtubule-based, ATP-dependent functions. Their motor domain drives these activities, but the molecular adaptations that specify these diverse and essential cellular activities are poorly understood. It has been assumed that the first identified kinesin--the transport motor kinesin-1--is the mechanistic paradigm for the entire superfamily, but accumulating evidence suggests otherwise. To address the deficits in our understanding of the molecular basis of functional divergence within the kinesin superfamily, we studied kinesin-5s, which are essential mitotic motors whose inhibition blocks cell division...
February 4, 2014: Proceedings of the National Academy of Sciences of the United States of America
https://www.readbyqxmd.com/read/24347131/retrograde-mechanochemical-ablation-of-the-small-saphenous-vein-for-the-treatment-of-a-venous-ulcer
#20
Hayley M Moore, Tristan R A Lane, Ian J Franklin, Alun H Davies
We present the first case of retrograde ablation of the small saphenous vein to treat active venous ulceration. A 73-year-old gentleman with complicated varicose veins of the left leg and a non-healing venous ulcer despite previous successful endovenous treatment to his left great saphenous vein underwent mechanochemical ablation of his small saphenous vein with the ClariVein® system, under local anaesthetic, using a retrograde cannulation technique. Post-operatively the patient had improved symptomatically and the ulcer size had reduced...
October 2014: Vascular
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