Treatment of anterior saphenous vein incompetence with mechanochemical endovenous ablation

BackgroundMechanochemical endovenous ablation (MOCA) is an established non-thermal technique for treating varicose veins of the great and small saphenous veins, GSV and SSV, with diameters under 12 mm. However, its safety and efficacy in treating anterior saphenous vein (ASV) incompetence remain unclear. This study evaluated the feasibility, safety, and effectiveness of MOCA for ASV reflux.MethodsIn this prospective single-centre registry, 30 patients with symptomatic ASV incompetence underwent MOCA using the ClariVein® system. Anatomical success, clinical improvement (VCSS), pain scores, return to normal activities, and complications were assessed at 30-days and 12-months follow-up. Procedural duration and duplex ultrasound results were also recorded.ResultsTechnical success was achieved in 93.3% (28/30) of patients. Median procedure time was 9.0 min (IQR 7.0-11.5). Median peri-procedural and postoperative pain scores were 3.0 and 1.0, respectively, and most patients resumed normal activities within 1 day. At 30 days, anatomical success was 96.3%, and median VCSS improved from 5.0 to 3.0. At 12 months, duplex ultrasound was available in 25 patients, with evaluable data in 23. Complete occlusion was observed in 82.6%, partial in 4.3%, and no occlusion in 13.0%. Minor complications occurred in 25.0%, and one deep vein thrombosis was recorded. At 1 year, the mean AVVQ score improved by 6.7 points, and RAND-36 scores showed favourable outcomes in pain (81), mental health (85), and general health (64).ConclusionMOCA with the ClariVein® system appears safe, effective, and well-tolerated for ASV incompetence. Larger studies with longer follow-up are warranted.