Safe, patient-friendly technique for treating varicose veins

Mechanochemical endovenous ablation is a new technique, whereby a varicose vein is closed off using a catheter with a rotating wire in combination with sclerotherapy. The treatment is both safe and effective, and patients suffer less pain during and after the procedure than with the current thermal techniques. They recover more quickly and are able to resume work sooner. These are the results of research by UMCG PhD candidate Ramon van Eekeren, who works as a surgeon in Arnhem. He will defend his thesis on 1 April at the University of Groningen.

Veins are responsible for transporting blood back to the heart. Varicose veins (varices) develop when the veins widen, preventing the valves that are supposed to stop blood flowing back in the wrong direction from doing their job. The blood is able to flow backwards and the pressure in the veins increases. Varicose veins are a common disorder. The symptoms vary from slight itching or fatigue in the legs to serious venous leg ulcers.

Stripping varicose veins has been the usual treatment method for more than a hundred years. Minimally invasive techniques developed over the last few decades have vastly improved the effectiveness, quality of life and cosmetic outcome for patients. Most methods are based on heat combined with an analgesic fluid to obliterate the affected vein. Analgesic injections are time-consuming and painful, and still thermal ablation can lead to complications such as burns to the skin, injury to nerves and long-term pain.

In his thesis, Ramon van Eekeren explores a new minimally invasive technique known as MOCA (mechanochemical endovenous ablation). This procedure is carried out without heat or analgesics and without the risk of heat-related complications. MOCA involves inserting a thin catheter into the vein. The catheter is fitted with a metal wire with a tiny metal ball at the tip. The wire can rotate, causing a minimum of damage to the inside of the vein. At the same time, a hardening agent (sclerosant) is injected into the vein. This attaches itself to the inside, causing the varicose vein to shrivel and close.

Van Eekeren studied 106 patients who had been treated with this procedure. His research shows that MOCA is a safe and effective treatment for varicose veins. MOCA is also less painful than other procedures, both during and after the treatment. As a result, patients recover more quickly and on average, are able to return to work after just one day. He monitored this group at three different points in time (6 weeks, 6 months and a year after the procedure).

According to Van Eekeren, it is important to know whether these positive results will be sustained in the long term as long-term results will be the ultimate test of the success of this new technique for treating patients with varicose veins.

R.R.J.P. van Eekeren (Bergen op Zoom, 1979) studied medicine at Radboud University Nijmegen. He conducted his research at the Research Institute GUIDE of the UMCG. His thesis is entitled: ‘Mechanochemical endovenous ablation in the treatment of varicose veins’. Van Eekeren currently works as an oncological surgeon at the Rijnstate Hospital in Arnhem.

Source: press release UMCG