Comparative Study Between Antegrade VS Retrograde Mechano-Chemical Ablation (MOCA) of Great Saphenous Vein Reflux

Background: Varicose veins are the commonest problem that causes significant Morbidity in the lower limbs and thus leads to increased healthcare cost. Symptoms include pain, itching, burning, discomfort, swelling, postural cramps, night cramps and further it may lead to ulcer formation which is difficult to heal. Surgery is the gold standard in the treatment of varicose veins but Mechano-Chemical Ablation is newer minimally invasive technique that is available for the treatment of varicose veins. Objective: To compare the results, advantage, disadvantage and complications of Antegrade Vs Retrograde Mechano-Chemical Ablation of Great Saphenous Vein Reflux.Patients and Methods: This was a prospective randomized clinical trial that was conducted on 60 patients diagnosed with GSV reflux in Department of surgery - vascular unit of Benha University Hospitals and Department of Vascular surgery - Maadi Armed Forces Hospital to compare between antegrade and retrograde mechanochemical ablation (MOCA). Results: DVT after procedure was significantly higher in antegrade mechanochemical ablation group (p =0.04). There were no significant difference between both groups as regard Patient satisfaction and postoperative complications (itching, ulcers, superficial thrombophlebitis, hematoma) between the studied groups.Conclusion: Antegrade MOCA seems to be superior to retrograde MOCA for treating primary varicose veins, as it is technically feasible, with short operative time, provides good clinical results, short recovery time, early return to work and better clinical outcomes although DVT after procedure was significantly higher in antegrade than retrograde mechanochemical ablation (MOCA). Antegarde and retrograde mechanochemical ablation are both related to an improvement in quality of life.