Vos CG, Ünlü Ç, Bosma J, van Vlijmen CJ, de Nie AJ, Schreve MA, et al.
Journal of vascular surgery. Venous and lymphatic disorders. Date of publication 2017 Nov 1;volume 5(6):880-896.
1. J Vasc Surg Venous Lymphat Disord. 2017 Nov;5(6):880-896. doi:
10.1016/j.jvsv.2017.05.022. Epub 2017 Jul 21.
A systematic review and meta-analysis of two novel techniques of nonthermal
endovenous ablation of the great saphenous vein.
Vos CG(1), Ünlü Ç(2), Bosma J(3), van Vlijmen CJ(4), de Nie AJ(2), Schreve
MA(2).
Author information:
(1)Department of Surgery, Northwest Clinics, Alkmaar, The Netherlands.
Electronic address: ncgvos@gmail.com.
(2)Department of Surgery, Northwest Clinics, Alkmaar, The Netherlands.
(3)Department of Surgery, Onze Lieve Vrouwe Gasthuis, Amsterdam, The
Netherlands.
(4)Department of Surgery, Centrum Oosterwal, Alkmaar, The Netherlands.
BACKGROUND: Endothermal treatment of the great saphenous vein (GSV) has become
the first-line treatment for superficial venous reflux. Nonthermal ablation has
potential benefits for acceptability by patients and decreased risk of nerve
injury. We performed a systematic review and meta-analysis to evaluate the
efficacy of mechanochemical endovenous ablation (MOCA) and cyanoacrylate vein
ablation (CAVA) for GSV incompetence.
METHODS: MEDLINE, Embase, Cumulative Index to Nursing and Allied Health
Literature, and Cochrane databases were searched for papers published between
January 1966 and December 2016. Eligible articles were prospective studies that
included patients treated for GSV incompetence and described the primary
outcome. Exclusion criteria were full text not available, case reports,
retrospective studies, small series (n < 10), reviews, abstracts, animal
studies, studies of small saphenous vein incompetence, and recurrent GSV
incompetence. Primary outcome was anatomic success. Secondary outcomes were
initial technical success, Venous Clinical Severity Score, Aberdeen Varicose
Vein Questionnaire score, and complications.
RESULTS: Fifteen articles met the inclusion criteria. Pooled anatomic success
for MOCA and CAVA was 94.7% and 94.8% at 6 months and 94.1% and 89.0% at 1 year,
respectively. Venous Clinical Severity Score and Aberdeen Varicose Vein
Questionnaire score significantly improved after treatment with MOCA and CAVA.
CONCLUSIONS: These results are promising for these novel techniques that could
serve as alternatives for thermal ablation techniques. However, to determine
their exact role in clinical practice, high-quality randomized controlled trials
comparing these novel modalities with well-established techniques are required.
Copyright © 2017 Society for Vascular Surgery. Published by Elsevier Inc. All
rights reserved.
DOI: 10.1016/j.jvsv.2017.05.022
PMID: 29037363 [Indexed for MEDLINE]
