Feasibility and Short-Term Complication Rate of Mechanochemical Ablation for Epifascial Tributaries of Incompetent Great Saphenous Veins.

OBJECTIVE: The aim of this study was to investigate the occurrence of skin complications following mechanochemical ablation (MOCA) with the ClariVein device for incompetent great saphenous veins (GSVs) and to compare the results in terms of target vein characteristics, particularly the presence of an epifascial GSV tributary.

METHODS: A single-center, retrospective study was performed. We reviewed a total of 33 limbs of 32 patients with GSV insufficiency who underwent MOCA with the ClariVein device from December 2017 to February 2020. The 33 limbs were divided into two groups: epifascial group, comprising 11 limbs of 11 patients, and non-epifascial group, comprising 22 limbs of 21 patients. Patients underwent postoperative follow ups at 1 week and 1, 3, 6 and 12 months. Skin complication counts and scores on a 4-point scale were recorded.

RESULTS: Regarding baseline characteristics, the epifascial group showed significantly lower GSV depth in the distal thigh region compared to the non-epifascial group (2.64 ± 0.5 vs. 7.05 ± 2.57 mm, p < 0.001). There was no statistically significant difference between the two groups in terms of the sclerosant (sodium tetradecyl sulfate) volume (5.45 ± 2.02 vs. 6.59 ± 1.79 mL, p = 0.109) or ablation length (31.82 ± 3.92 vs. 32.95 ± 4.05 cm, p = 0.449). All ClariVein procedures were technically successful (33 of 33 limbs, 100%), and no major complications were reported. The hyperpigmentation score was significantly higher in the epifascial group compared to the non-epifascial group (0.18 ± 0.4 vs. 0 ± 0, p = 0.0401), while the hyperpigmentation count was not significantly different between the groups (two of 11 limbs, 18.2% vs. 0 of 22 limbs, 0.0%; p = 0.1042). Although marginally higher counts and scores were observed in terms of phlebitis and bruising in the epifascial group, these differences were not statistically significant.

CONCLUSION: Endovenous treatment with ClariVein for incompetent GSV can be performed safely. However, caution should be exercised when the epifascial GSV tributary is treated during the ClariVein procedure because of its predilection to hyperpigmentation.