1. Three-year results of a randomized controlled trial comparing mechanochemical and thermal ablation in the treatment of insufficient great saphenous veins.
- Author
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Vähäaho S, Halmesmäki K, Mahmoud O, Albäck A, Noronen K, and Venermo M
- Subjects
- Adult, Aged, Ambulatory Care Facilities, Ambulatory Surgical Procedures, Female, Finland, Humans, Male, Middle Aged, Quality of Life, Saphenous Vein diagnostic imaging, Saphenous Vein physiopathology, Sclerosing Solutions administration & dosage, Sclerotherapy, Sodium Tetradecyl Sulfate administration & dosage, Time Factors, Treatment Outcome, Ultrasonography, Doppler, Duplex, Venous Insufficiency diagnostic imaging, Venous Insufficiency physiopathology, Young Adult, Catheter Ablation adverse effects, Endovascular Procedures adverse effects, Laser Therapy adverse effects, Saphenous Vein surgery, Venous Insufficiency surgery
- Abstract
Objective: Mechanochemical ablation (MOCA) is a nonthermal nontumescent method of treating saphenous vein insufficiency. The feasibility and short-term results of MOCA are good, but its long-term results are unknown. A randomized study was performed to compare MOCA with endovenous laser ablation (EVLA) and radiofrequency ablation (RFA) in the setting of unilateral great saphenous vein (GSV) insufficiency., Methods: Venous outpatient clinic patients with varicose veins (CEAP class C2-C4) caused by GSV insufficiency were invited to participate in the study; in total, 132 patients met the inclusion criteria and were willing to participate. Patients were randomized to treatment (2:1:1 for MOCA, EVLA, and RFA, respectively). The state of the GSV with duplex Doppler ultrasound examination and the disease-specific quality of life were assessed at 1 month, 1 year, and 3 years after the treatment., Results: Some patients declined to continue in the study after randomization; in total, 117 patients underwent treatment. At 3 years, the occlusion rate was significantly lower with MOCA than with either EVLA or RFA (82% vs 100%; P = .005). Quality of life was similar between the groups. In the MOCA group, GSVs that were larger than 7 mm in diameter preoperatively were more likely to recanalize during the follow-up period. The partial recanalizations of proximal GSV observed at 1 year progressed during the follow-up., Conclusions: MOCA is a feasible treatment option in an outpatient setting, but its technical success rates are inferior compared with endovenous thermal ablation. Its use in large-caliber veins should be considered carefully., (Copyright © 2020 Society for Vascular Surgery. Published by Elsevier Inc. All rights reserved.)
- Published
- 2021
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