March 18, 2020
Study Compares Outcomes of Varicose Vein Treatments
March 18, 2020—Findings from a randomized clinical trial comparing endovenous laser ablation (EVLA) versus mechanochemical ablation (MOCA) in the treatment of primary varicose veins were published by Ahmed M. Tawfik, MD, et al in Journal of Vascular Surgery: Venous and Lymphatic Disorders (JVS-VL; 2020;8:211–215).
The investigators concluded that MOCA for treating primary varicose veins is a feasible, effective, and safe procedure with better clinical outcomes and a lower rate of postoperative phlebitis when compared with EVLA.
As summarized in JVS-VL, the investigators prospectively recruited 100 patients with primary varicose veins. The patients were randomly and equally allocated to one of two treatment groups: EVLA (n = 50) or MOCA (n = 50). Before intervention, all patients underwent clinical and ultrasound assessment of the vascular system. The Venous Clinical Severity Score was used to assess clinical severity. In addition, patients completed the Chronic Venous Insufficiency Questionnaire.
The primary study outcome was treatment success. After intervention, patients were followed up at 1 week, 1 month, 6 months, and 12 months.
In JVS-VL, the investigators reported the following:
- Operative success was achieved in all patients.
- The MOCA group had a significantly shorter operative time compared with the EVLA group.
- The Venous Clinical Severity Score significantly improved in both groups throughout the follow-up period and showed significantly lower levels in the MOCA group.
- Perceived pain was significantly improved in both groups postoperatively with no significant differences.
- The Chronic Venous Insufficiency Questionnaire was significantly improved after 12 months of operation without significant differences between the groups.
- MOCA patients had a significantly lower rate of postoperative phlebitis and a significantly shorter time to return to work.