Topic: ClariVein – Tips and Tricks using MOCA for CVI and Varicose Veins

Abstract

The management of chronic venous insufficiency (CVI) and varicose veins has undergone an industrial revolution over the past decade, with endothermal ablation replacing open high tie and truncal vein stripping surgery as the ‘‘gold standard’’ treatment. These minimally
invasive endovenous techniques performed usually under local anaethesia, have allowed a faster return to normal daily activities and a more rapid enhancement in quality of life (QoL) for the patient. Non-thermal, non-tumescent (NTNT) endovenous technologies have been introduced to obviate the need for tumescent infiltration for endothermal ablation and to enhance the patient’s experience even further both intra-procedurally and post-operatively. This focus on patient satisfaction bears importance given the fact that the decision to intervene in the majority of cases is based on symptomatology and QoL issues.
The ClariVein occlusion catheter system (Merit Medical, Quincy) is an example of a NTNT device that induces endovenous closure by a combination of mechanical damage to the
endothelial cells of the vein wall and chemical injury with a liquid sclerosant infusion that causes apoptosis and vein fibrosis (mechano-chemical ablation or MOCA). It has been shown to be safe and efficacious in its initial trials in both Caucasians and Asians.
The aims of this talk are to describe:
• What type of patients should be suitable for MOCA treatment?
• How to manage Bilateral Varicose Veins with the ClariVein device
• How to enhance longer lasting ablation with MOCA
• MOCA or Glue? How should we select?