Department of Surgery, NijSmellinghe Hospital, Drachten, Netherlands.
Department of Surgery, Rijnstate Hospital, Arnhem, Netherlands.
Phlebology. 2024 Feb;39(1):9-19. doi: 10.1177/02683555231202181. Epub 2023 Sep 15.
Mechanochemical endovenous ablation (MOCA) was introduced to treat superficial venous insufficiency of the lower leg with less pain and haematoma. Long-term outcome is still lacking. The purpose was to report long-term outcome and to analyse possible predictors for failure.
The study was a retrospective pooled analysis of two prospective cohorts previously reported, but with prolonged long-term outcome up to 5-years follow-up.
163 treated legs were analysed. Mean follow-up was 5.4±0.6 years, in which 33 total failures occurred. Four procedures were partially successful. VCSS improved significantly and remained stable after 1 and 2-years, but significantly rose again after 5-years. AVVQ dropped significantly, but increased after 1 year to 4.3 and 6.1 at 5-years follow-up.
MOCA was effective with minimal pain perioperative. However, anatomical success deteriorated after 1-year and showed even less results after 5-years, mainly due to partly recanalization, while clinical results were less affected. There were no clear clinical predictors for failure.
机械化学静脉内消融术（MOCA）被引入以治疗小腿的浅表静脉功能不全，具有较少的疼痛和血肿。但长期结果仍缺乏。目的是报告长期结果，并分析可能的失败预测因素。
本研究是以前报道的两个前瞻性队列的回顾性汇总分析，但随访时间延长至 5 年。
分析了 163 条治疗腿。平均随访时间为 5.4±0.6 年，其中发生了 33 次总失败。4 例部分成功。VCSS 显著改善，并在 1 年和 2 年时保持稳定，但在 5 年后再次显著升高。AVVQ 显著下降，但在 1 年后增加至 4.3，5 年后随访时增加至 6.1。
MOCA 具有最小的围手术期疼痛，效果显著。然而，解剖学上的成功在 1 年后恶化，在 5 年后的结果甚至更少，主要是由于部分再通，而临床结果受影响较小。没有明确的临床失败预测因素。
