Great saphenous vein mechanochemical Sclerotherapy versus Laser ablation in treatment of varicose vein

Abstract

The “gold standard” for the treatment of insufficient saphenous veins has been ligation plus stripping for the past 100 years. This situation has changed in the last decade with the introduction of endovenous thermal ablation techniques. A new generation of devices for endovenous ablation of truncal veins has been emerging in recent years. The new devices such as glue and mechanochemical ablation aim to avoid the use of heat as energy source and associated requirement for tumescence around the vein (Guo & Tjosvold, 2016). EVTA and MOCA techniques are always performed under duplex guidance and are proving to be very effective with high success rates at short-term follow-up. As the effectiveness of current EVTA treatments is excellent (>90%), side-effects are mild, and serious complications rare, any new EVTA Procedure should at least perform equally or preferably have some advantages over existing techniques. The hypothesis is that MOCA will be at least as effective as EVLA or RFA. Future studies should compare the different endovenous treatments in terms of effectiveness and patient-reported outcomes. Further work is also required to try to answer the remaining questions about the exact working mechanism of the different endovenous treatments. In an era of health technology assessment and cost effectiveness analyses, treatment-related costs will become increasingly important and endovenous this will remain a crucial issue in the future.