4. Mechanoablation

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CLARIVEIN.
M. Reijnen

Mechanicochemical ablation (MOCA) is a new technique for saphenous vein treatment. It combines mechanical endothelial damage using a rotating wire with the infusion of a liquid sclerosant. Heating the vein and tumescent anesthesia are not required, only local anesthesia is used at the insertion site. As MOCA generates no heat, it is related to a very low incidence of major complications. It is a fast and safe technique for both great saphenous vein (GSV) and small saphenous vein (SSV) insufficiency. The early results are promising with acceptable closure rates (88% at 1 year with three partial recanalizations and one complete recanalization). There is a learning curve, which seems to be less forgiving than laser or radiofrequency ablation. We have no data concerning the optimal dose of sclerosant and the pullback rate that should be apply. We also need results about long-term and comparative data from randomized controlled trials (RCTs); the Maradona trial compares MOCA and ClosureFast for GSV insufficiency.