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Early results of application of the system of mechanochemical obliteration of varicose veins for the treatment of varicose veins

https://doi.org/10.21518/1995-1477-2021-18-2-32-36

Abstract

Introduction. The basis of varicose veins is reflux in the great saphenous veins, and at present one of the basic principles of treating varicose veins is to eliminate reflux. Thermal obliteration is the gold standard, but non-thermal non-tumescent methods have several advantages.

Target. Evaluation of the safety and effectiveness of mechanochemical obliteration in patients with venous insufficiency using the Flebogrif catheter.

Materials and methods. The study included 8 women and 2 men over 18 years of age with reflux along the GSV with a target vein diameter of no more than 12 mm. The average age of the patients was 43.8 ± 11.5 years. Stage C2 (varicose saphenous veins) was detected in six patients (60%), stage C3 (edema) in 3 patients (30%), stage C4a (trophic changes of skin and subcutaneous tissues, hyperpigmentation and/or varicose eczema) in one patient (10%). Results. After the procedure, complete occlusion of the target segments of the varicose vein was achieved in 100 percent of cases (10 patients) at all study periods (up to 2 months). Palpation in the projection of the target vein was painless in all patients. The ultrasound imaging showed complete occlusion of the target vein and the absence of complete or segmented recanalization in all patients during all postoperative examinations. No adverse events or complications were reported.

Conclusions. Mechanochemical obliteration is a reliable way to eliminate vertical reflux. The main advantages for the patient are speed, painlessness, beauty and outpatient procedures. A big plus for the doctor, in addition to the speed of the intervention and patient satisfaction, is the absence of the need for complex technical devices (thermogenerators), as well as the absence of the need for tumescent anesthesia, which makes the procedure more comfortable for the patient.

About the Authors

K. V. Kurginyan
Medical Center “Medskan”
Russian Federation

Khachatur M. Kurginyan, Vascular Surgeon, Phlebologist, Director General

21, Letter A, Obruchev St., Moscow, 119421



V. V. Raskin
Medical Innovative Phlebological Center
Russian Federation

Vladimir V. Raskin, Cand. Sci. (Med.), Vascular Surgeon, Phlebologist, Expert Sonographer, Lead Employer

7, Bldg. 1, Yakornaya St., Moscow, 115407



S. M. Markin
St Petersburg Clinical Hospital of the Russian Academy of Sciences
Russian Federation

Sergey M. Markin, Cand. Sci. (Med.), Surgeon, Head of the Phlebology Center

72, Letter A, Torez Ave., St Petersburg, 194017



References

1. Whiteley M.S., Dos Santos S.J., Lee C.T., J.-M.Li. Mechanochemical ablation causes endothelial and medial damage to the vein wall resulting in deeper penetration of sclerosant compared with sclerotherapy alone in extrafascial great saphenous vein using an ex vivo model. J Vasc Surg Venous Lymphat Disord. 2017;5(3):370–377. https://doi.org/10.1016/j.jvsv.2016.12.009.

2. Boersma D., van Haelst S.T., van Eekeren R.R., Vink A., Reijnen M.M., de Vries J.P., de Borst G.J. Macroscopic and Histologic Analysis of Vessel Wall Reaction After Mechanochemical Endovenous Ablation Using the ClariVein OC Device in an Animal Model. Eur J Vasc Endovasc Surg. 2017;53(2):290–298. https://doi.org/10.1016/j.ejvs.2016.11.024.

3. Ontario Health (Quality) . Nonthermal Endovenous Procedures for Varicose Veins: A Health Technology Assessment. Ont Health Technol Assess Ser. 2021;21(8):1–188. Available at: https://pubmed.ncbi.nlm.nih.gov/34211617.

4. Alozai T., Huizing E., Schreve M., van Vlijmen C.J., Wisselink W., Ünlü Ç. A systematic review and meta-analysis of mechanochemical endovenous ablation using Flebogrif for varicose veins: A summary of evidence. J Vasc Surg Venous Lymphat Disord. 2021. https://doi.org/10.1016/j.jvsv.2021.05.010.

5. Ammollo R.P., Petrone A., Giribono A.M., Ferrante L., Del Guercio L, Bracale U.M. Early Results of Mechanochemical Ablation with Flebogrif in great Saphenous Vein Insufficiency: does Polidocanol Concentration Affect Outcome? Transl Med UniSa. 2020;21:47–51. Available at: https://pubmed.ncbi.nlm.nih.gov/32123682.

6. Zubilewicz T., Terlecki P., Terlecki K., Przywara S., Rybak J., Ilzecki M. Application of endovenous mechanochemical ablation (MOCA) with FlebogrifTM to treat varicose veins of the lower extremities: a single center experience over 3 months of observation. Acta Angiol. 2016;22(4):137–142. https://doi.org/10.5603/AA.2016.0012.

7. Tawfik A.M., Sorour W.A., El-Laboudy M.E. Laser ablation versus mechanochemical ablation in the treatment of primary varicose veins: A randomized clinical trial. J Vasc Surg Venous Lymphat Disord. 2020;8(2):211–215. https://doi.org/10.1016/j.jvsv.2019.10.025.


Review

For citations:


Kurginyan K.V., Raskin V.V., Markin S.M. Early results of application of the system of mechanochemical obliteration of varicose veins for the treatment of varicose veins. Ambulatornaya khirurgiya = Ambulatory Surgery (Russia). 2021;18(2):32-36. (In Russ.) https://doi.org/10.21518/1995-1477-2021-18-2-32-36

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ISSN 2712-8741 (Print)
ISSN 2782-2591 (Online)