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Tjun Y Tang
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October 14, 2016: Journal of Endovascular Therapy
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
Tristan Lane, Roshan Bootun, Brahman Dharmarajah, Chung S Lim, Mojahid Najem, Sophie Renton, Kaji Sritharan, Alun H Davies
BACKGROUND: Endovenous thermal ablation has revolutionised varicose vein treatment. New non-thermal techniques such as mechanical occlusion chemically assisted endovenous ablation (MOCA) allow treatment of entire trunks with single anaesthetic injections. Previous non-randomised work has shown reduced pain post-operatively with MOCA. This study presents a multi-centre randomised controlled trial assessing the difference in pain during truncal ablation using MOCA and radiofrequency endovenous ablation (RFA) with six months' follow-up...
May 24, 2016: Phlebology
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
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
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
Y L Lam, Irwin M Toonder, Cees H A Wittens
OBJECTIVES: The ClariVein® system is an endovenous technique that uses mechano-chemical ablation to treat incompetent truncal veins. This study was conducted to identify the ideal Polidocanol dosage and form for mechano-chemical ablation in order to occlude the great saphenous vein. When adhering to safe dosage levels, sclerosants with higher concentrations potentially limit the extent of treatment. It has been demonstrated that this problem may be overcome by using Polidocanol as a microfoam...
April 2016: Phlebology
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
Maciej Chwała, Wojciech Szczeklik, Michał Szczeklik, Tomasz Aleksiejew-Kleszczyński, Maria Jagielska-Chwała
Chronic venous insufficiency is one of the most common disorders of the vascular system, affecting approximately 50% of adults. If left untreated it can lead to a number of complications, including venous ulceration and venous thrombosis. This review paper outlines the epidemiology and ethiopathogenesis of the disease with regard to hemodynamics and microcirculation disturbances. It describes the medical treatment as well as the traditional surgical approach to varicose veins (with several modifications of this technique), and its limitations and contraindications...
January 2015: Advances in Clinical and Experimental Medicine: Official Organ Wroclaw Medical University
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
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
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
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
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
Jean-Jérôme Guex
The constant evolution of endo-venous ablative techniques for varicose veins arises from the need for: better patient's comfort, reduced incidence of side effects, better results at short-, mid- and long-term follow-up, as well as reduction of operating time and technical simplicity. All these goals have been aimed at but so far no new technology has been able to achieve them all or to demonstrate it, furthermore the increase of price must be compensated by a considerable improvement of results and a serious reduction of side effects to be incrementally cost effective...
May 19, 2014: Phlebology
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
Richard L Mueller, Jeffrey K Raines
OBJECTIVES: The 2 primary objectives of this publication are to provide a practical step-by-step procedure for the ClariVein system and a focused literature review of endovenous ablation. MATERIALS AND METHODS: The ClariVein system is the first venous ablation technique to employ a hybrid (dual-injury) technique built into 1 catheter-based delivery system. Endomechanical abrasion is produced by the tip of the catheter's rotating wire (mechanical component); and endovenous chemical ablation (EVCA) is via simultaneous injection of sclerosant over the rotating wire (chemical component)...
April 2013: Vascular and Endovascular Surgery
J Lawson, S Gauw, C van Vlijmen, P Pronk, M Gaastra, M Mooij, C H A Wittens
Less invasive endovenous techniques have been shown to be as effective as open surgery in the treatment of varicose veins. Furthermore, they cause less postoperative bruising and pain and enable early return to normal activities and work. Tumescent anaesthesia is safe and obviates complications of general or spinal anaesthesia. Drawbacks are a steep learning curve and painful administration during treatment. Tumescentless techniques like Clarivein™ or VenaSeal™ Sapheon Closure System are recently under investigation...
March 2013: Phlebology
Michael Kendler, Marco Averbeck, Jan C Simon, Mirjana Ziemer
BACKGROUND: Endovenous treatment modalities are used increasingly to treat varicose veins. The ClariVein® catheter is a new endoluminal mechanico-chemical obliteration technique which can be used without tumescent anesthesia. It is still unclear what changes the mechanical tip of the catheter has on the walls of the vein. PATIENTS AND METHODS: Five great saphenous vein specimens were obtained atraumatically by crossectomy. Then the veins were treated ex vivo with the ClariVein® catheter without sclerotherapy...
April 2013: Journal der Deutschen Dermatologischen Gesellschaft, Journal of the German Society of Dermatology: JDDG
D Boersma, R R J P van Eekeren, D A B Werson, R I F van der Waal, M M J P Reijnen, J-P P M de Vries
OBJECTIVE: This study evaluated the feasibility, safety and 1-year results of mechanochemical endovenous ablation (MOCA™) of small saphenous vein (SSV) insufficiency. DESIGN: Prospective cohort study. MATERIALS AND METHODS: Fifty consecutive patients were treated for primary SSV insufficiency with MOCA™ using the ClariVein(®) device and polidocanol. Initial technical success, complications, patient satisfaction and visual analogue scale (VAS) pain score were assessed...
March 2013: European Journal of Vascular and Endovascular Surgery
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