Early results of mechano-chemical ablation for small saphenous vein incompetency using 2% Polidocanol.

ABSTRACT Objective The aim of the study is to investigate the early results of mechanochemical ablation (MOCA) for the treatment of small saphenous vein (SSV) incompetence. Methods This is a single-center, retrospective analysis of a prospectively collected database of 60 patients treated with MOCA for single-axis SSV incompetence. All procedures were performed under local anesthesia using the ClariVein® catheter (Merit Medical, South Jordan, Utah, USA) combined with 2% Polidocanol and, where appropriate, additional micro-phlebectomies. The primary study endpoint was to assess the SSV occlusion rate at the 1-month, 6-month, and 1-year follow-ups. Secondary endpoints included the evaluation of the Venous Clinical Severity Score (VCSS), quality of life assessment (QoL), peri-procedural pain, and further complications after the intervention and over time. QoL was assessed using the Aberdeen Varicose Vein Questionnaire (AVVQ). Pain was measured on a 100-mm visual analog scale (VAS). Results Technical success was achieved in 100% of cases. The mean VAS score on the first post-operative day was 15 mm. No major events were recorded. In particular, no neurological complications or deep vein thrombosis was observed. Minor complications included ecchymosis in 3.3% of cases (2/60), transient phlebitis of the SSV in 5% of cases (3/60) and itching in 3.3% of cases (2/60). At the 1-month follow-up the occlusion rate was 100% (60/60), at the 6-month follow-up 98.3% (57/58), and at the 1-year follow-up 92.6% (50/54). The median VCSS significantly decreased from 5 [interquartile range (IQR) 3-6] at baseline to 2 (IQR 1-4) at the 1-month follow-up (p Conclusions MOCA is a feasible, safe, and painless procedure for the treatment of SSV incompetence with an occlusion rate of 92.6% at the 1-year follow-up. No sural nerve injuries or other major complications were observed. The procedure also shows good clinical results and a positive impact on patients’ QoL.