Histological observations one year after mechanochemical endovenous ablation of the great saphenous vein.

PURPOSE

To report histological analysis of a great saphenous vein (GSV) 1 year after undergoing mechanochemical endovenous ablation (MOCA) and compare the findings with those of a healthy vein.

CASE REPORT

A 59-year-old patient with bilateral GSV incompetence was treated with MOCA using the ClariVein catheter, which has a dispersion wire that rotates as liquid sclerosant is injected in the vein. After 1 year, the patient had recurrent edema of the right leg; duplex ultrasound was suspicious for recanalization. The patient was reoperated, and the deep femoral vein was explored. The GSV was completely obliterated, and its proximal part was excised and sent for histological processing. Microscopic evaluation of the MOCA-treated vein showed a circumferential disappearance of the endothelial layer and fibrosis of the vein. The media was considerably damaged, with changes in collagen structure, supporting the therapeutic effect of MOCA.

CONCLUSION

MOCA is a novel endovenous treatment modality for saphenous vein insufficiency. Results of MOCA on the cellular level are essential to optimize treatment.