RR25. Mechano-Chemical Endovenous Ablation in Great and Small Saphenous Vein Incompetence Using ClariVein TM: Initial Results of an Innovative Tumescentless Technique

Most endovenous techniques for treatment of great saphenous vein incompetence use thermal energy, which requires instillation of tumescence anaesthesia and may lead to heat-related nerve damage. The innovative mechanochemical endovenous ablation (MECEA) of the great and small saphenous vein was recently developed to induces occlusion by endovenous mechanical damage combined with infusion of a liquid sclerosans. Initial results. Prospective study of 110 consecutive patients, treated for 126 insufficient veins with MECEA using ClariVeinTM device (Vascular Insights, USA) and aetoxysklerol. Initial technical success (obliteration at post-procedural duplex scan), complications, patient satisfaction and visual analogue scale painscore (VAS) were assessed. Follow up included duplex scan of treated veins. Inclusion criteria: 1. Venous incompetence of GSV, SSV or anterolateral side branches (ASB). 2. Vein diameter of 3 to 11mm. 3. Length of incompetence > 15 cm. From June to December 2010 126 legs were treated (107 GSV, 13 SSV, 6 ASB). The median length of treated veins was 37cm (16-52). Initial technical success of MECEA was 100%. Median (VAS) painscore was 3 (0-10). No nerve damage occurred. The majority of patients already had 6 weeks follow-up duplex scan: 76 of 77 patients (98%) had obliteration of the treated vein. In one patient total recanalisation occurred, she had successful renewed MECEA. Four patients had 6 months duplex scans and all veins remained obliterated. No patients suffered from major complications; local hematoma at the puncture site was seen in 26%and superficial trombophlebitis in 23%, resolving within a week. Mechanochemical obliteration of long segment GSV, SSV and ASB incompetence is feasible with 100% initial technical success in this first large series. VAS scores are low and no tumescent anesthesia is necessary. Short-term follow-up is encouraging, and a Dutch registry has been started to gather longer-term follow-up.