Three-year results of a randomized controlled trial comparing mechanochemical and thermal ablation in the treatment of insufficient great saphenous veins

Autor: Karoliina Halmesmäki, Maarit Venermo, Osman Mahmoud, Katariina Noronen, S. Vähäaho, Anders Albäck
Přispěvatelé: HUS Abdominal Center, Verisuonikirurgian yksikkö, HYKS erva, Päijät-Häme Welfare Consortium
Rok vydání: 2021
Předmět:
Male
Time Factors
Radiofrequency ablation
030204 cardiovascular system & hematology
Ambulatory Care Facilities
law.invention
Sodium Tetradecyl Sulfate
0302 clinical medicine
Randomized controlled trial
law
Occlusion
Medicine
Outpatient clinic
FOAM SCLEROTHERAPY
030212 general & internal medicine
ENDOVENOUS LASER-ABLATION
10. No inequality
Finland
Ultrasonography
Doppler
Duplex
Endovascular Procedures
Middle Aged
16. Peace & justice
3. Good health
Treatment Outcome
medicine.anatomical_structure
Varicose veins
Catheter Ablation
Female
Laser Therapy
5-YEAR FOLLOW-UP
medicine.symptom
Cardiology and Cardiovascular Medicine
Adult
medicine.medical_specialty
Randomization
CLINICAL-TRIAL
Young Adult
03 medical and health sciences
Sclerotherapy
Humans
VARICOSE-VEINS
Saphenous Vein
CLARIVEIN(R)
Vein
Aged
business.industry
Great saphenous vein
3126 Surgery
anesthesiology
intensive care
radiology
Sclerosing Solutions
Laser ablation
Surgery
Venous insufficiency
Ambulatory Surgical Procedures
Quality of Life
business
Zdroj: Journal of Vascular Surgery: Venous and Lymphatic Disorders. 9:652-659
ISSN: 2213-333X
DOI: 10.1016/j.jvsv.2020.08.007
Popis: 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.
Databáze: OpenAIRE
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