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Michel M.j.p. Reijnen - One of the best experts on this subject based on the ideXlab platform.
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midterm outcome of mechanochemical endovenous ablation for the treatment of great saphenous Vein Insufficiency
Journal of Endovascular Therapy, 2017Co-Authors: Marianne E Witte, R.r.j.p. Van Eekeren, Jean-paul P.m. De Vries, Suzanne Holewijn, Clark J Zeebregts, Michel M.j.p. ReijnenAbstract:Purpose: To report the midterm results of mechanochemical ablation (MOCA) for treating great saphenous Vein (GSV) Insufficiency. Methods: In a 1-year period, 85 consecutive patients (median age 51....
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Treatment Modalities for Small Saphenous Vein Insufficiency: Systematic Review and Meta-analysis
Journal of endovascular therapy : an official journal of the International Society of Endovascular Specialists, 2015Co-Authors: Doeke Boersma, R.r.j.p. Van Eekeren, Michel M.j.p. Reijnen, Verena N. N. Kornmann, Ellen Tromp, Çağdaş Ünlü, Jean-paul P.m. De VriesAbstract:Purpose To investigate and compare the anatomical success rates and complications of the treatment modalities for small saphenous Vein (SSV) incompetence. Methods A systematic literature search was performed in PubMed, EMBASE, and the Cochrane Library on the following therapies for incompetence of SSVs: surgery, endovenous laser ablation (EVLA), radiofrequency ablation (RFA), ultrasound-guided foam sclerotherapy (UGFS), steam ablation, and mechanochemical endovenous ablation (MOCA). The search found 49 articles (5 randomized controlled trials, 44 cohort studies) reporting on the different treatment modalities: surgery (n=9), EVLA (n=28), RFA (n=9), UGFS (n=6), and MOCA (n=1). A random-effects model was used to estimate the primary outcome of anatomical success, which was defined as closure of the treated Vein on follow-up duplex ultrasound imaging. The estimate is reported with the 95% confidence interval (CI). Secondary outcomes were technical success and major complications [paresthesia and deep Vein thrombosis (DVT)], given as the weighted means. Results The pooled anatomical success rate was 58.0% (95% CI 40.9% to 75.0%) for surgery in 798 SSVs, 98.5% (95% CI 97.7% to 99.2%) for EVLA in 2950 SSVs, 97.1% (95% CI 94.3% to 99.9%) for RFA in 386 SSVs, and 63.6% (95% CI 47.1% to 80.1%) for UGFS in 494 SSVs. One study reported results of MOCA, with an anatomical success rate of 94%. Neurologic complications were most frequently reported after surgery (mean 19.6%) and thermal ablation (EVLA: mean 4.8%; RFA: mean 9.7%). Deep venous thrombosis was a rare complication (0% to 1.2%). Conclusion Endovenous thermal ablation (EVLA/RFA) should be preferred to surgery and foam sclerotherapy in the treatment of SSV incompetence. Although data on nonthermal techniques in SSV are still sparse, the potential benefits, especially the reduced risk of nerve injury, might be of considerable clinical importance.
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Mechanochemical endovenous ablation versus radiofrequency ablation in the treatment of primary small saphenous Vein Insufficiency (MESSI trial): study protocol for a randomized controlled trial
Trials, 2014Co-Authors: Doeke Boersma, R.r.j.p. Van Eekeren, Debora A.b. Werson, Michel M.j.p. Reijnen, Suzanne Holewijn, Michiel A Schreve, Hans Kelder, Jean-paul P.m. De VriesAbstract:Background Minimally invasive endothermal techniques, for example, radiofrequency ablation (RFA), have revolutionized the treatment of insufficient truncal Veins and are associated with an excellent outcome. The use of thermal energy requires the instillation of tumescent anesthesia around the Vein. Mechanochemical endovenous ablation (MOCA™) combines mechanical endothelial damage, using a rotating wire, with simultaneous infusion of a liquid sclerosans. Tumescent anesthesia is not required as no heat is used. Prospective studies using MOCA™ in both great and small saphenous Veins showed good anatomical and clinical results with fast postoperative recovery.
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mechanochemical endovenous ablation versus radiofrequency ablation in the treatment of primary small saphenous Vein Insufficiency messi trial study protocol for a randomized controlled trial
Trials, 2014Co-Authors: Doeke Boersma, R.r.j.p. Van Eekeren, Debora A.b. Werson, Michel M.j.p. Reijnen, Suzanne Holewijn, Michiel A Schreve, Hans Kelder, Jean-paul P.m. De VriesAbstract:Minimally invasive endothermal techniques, for example, radiofrequency ablation (RFA), have revolutionized the treatment of insufficient truncal Veins and are associated with an excellent outcome. The use of thermal energy requires the instillation of tumescent anesthesia around the Vein. Mechanochemical endovenous ablation (MOCA™) combines mechanical endothelial damage, using a rotating wire, with simultaneous infusion of a liquid sclerosans. Tumescent anesthesia is not required as no heat is used. Prospective studies using MOCA™ in both great and small saphenous Veins showed good anatomical and clinical results with fast postoperative recovery. The MESSI trial (Mechanochemical Endovenous ablation versus radiofrequency ablation in the treatment of primary Small Saphenous Vein Insufficiency) is a multicenter randomized controlled trial in which a total of 160 patients will be randomized (1:1) to MOCA™ or RFA. Consecutive patients with primary small saphenous Vein incompetence, who meet the eligibility criteria, will be invited to participate in this trial. The primary endpoint is anatomic success, defined as occlusion of the treated Veins objectified with duplex ultrasonography at 1 year follow-up. Secondary endpoints are post-procedural pain, initial technical success, clinical success, complications and the duration of the procedure. Initial technical success is defined as the ability to position the device adequately, treat the Veins as planned and occlude the treated Vein directly after the procedure has been proven by duplex ultrasonography. Clinical success is defined as an objective improvement of clinical outcome after treatment, measured with the Venous Clinical Severity Score (VCSS). Power analyses are conducted for anatomical success and post-procedural pain. Both groups will be evaluated on an intention-to-treat principle. The hypothesis of the MESSI trial is that the anatomic success rate of MOCA™ is not inferior to RFA. The second hypothesis is that post-procedural pain is significantly less after MOCA compared to RFA. Trial registration: NTR4613 Date of trial registration: 28 May 2014.
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mechanochemical endovenous ablation for the treatment of great saphenous Vein Insufficiency
Journal of vascular surgery. Venous and lymphatic disorders, 2014Co-Authors: R.r.j.p. Van Eekeren, Doeke Boersma, Debora A.b. Werson, Jean-paul P.m. De Vries, Suzanne Holewijn, Michel M.j.p. ReijnenAbstract:Objective: This study evaluated the feasibility, safety, and 1-year results of mechanochemical endovenous ablation (MOCA) of great saphenous Vein (GSV) Insufficiency. Methods: A consecutive 106 patients were treated for primary GSV Insufficiency with MOCA by the ClariVein device and polidocanol. The primary outcome measures were technical success, clinical success, and anatomic success after 1 year of follow-up. Secondary outcome measures were postprocedural pain, complications, general- and disease-specific quality of life, and time to return to work. Patients were evaluated with clinical examination and duplex ultrasonography at 6 weeks, 6 months, and 1 year after treatment. Results: The technical success was 99%. The mean postprocedural pain during the first 14 days after treatment was 7.5 mm (interquartile range [IQR], 0.0-10.0 mm) per day on a 0- to 100-mm visual analog scale. The time to return to normal activities and work was 1.0 day (IQR, 0-1.0 day) and 1.0 day (IQR, 1.0-4.0 days), respectively. No major complications were recorded. At 1-year follow-up, the clinical success was 93%. The Venous Clinical Severity Score decreased significantly from 4.0 (IQR, 3.0-5.0) before treatment to 1.0 (IQR, 0-1.0) (P < .001) 1 year after MOCA. At 1 year, 88.2% of the treated GSVs remained occluded as measured by duplex ultrasonography. Twelve patients had a recanalization, of which eight were partial. Disease-specific quality of life and the RAND 36-Item Health Survey scores improved significantly at 1-year follow-up. Conclusions: MOCA is a safe and effective technique in the treatment of GSV Insufficiency with good clinical and anatomic success at 1-year follow-up. The technique is related to low postprocedural pain scores, low complication rate, improved quality of life, and rapid resumption of normal activities and work. (J Vasc Surg: Venous and Lym Dis 2014;2:282-8.)
Jean-paul P.m. De Vries - One of the best experts on this subject based on the ideXlab platform.
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midterm outcome of mechanochemical endovenous ablation for the treatment of great saphenous Vein Insufficiency
Journal of Endovascular Therapy, 2017Co-Authors: Marianne E Witte, R.r.j.p. Van Eekeren, Jean-paul P.m. De Vries, Suzanne Holewijn, Clark J Zeebregts, Michel M.j.p. ReijnenAbstract:Purpose: To report the midterm results of mechanochemical ablation (MOCA) for treating great saphenous Vein (GSV) Insufficiency. Methods: In a 1-year period, 85 consecutive patients (median age 51....
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Treatment Modalities for Small Saphenous Vein Insufficiency: Systematic Review and Meta-analysis
Journal of endovascular therapy : an official journal of the International Society of Endovascular Specialists, 2015Co-Authors: Doeke Boersma, R.r.j.p. Van Eekeren, Michel M.j.p. Reijnen, Verena N. N. Kornmann, Ellen Tromp, Çağdaş Ünlü, Jean-paul P.m. De VriesAbstract:Purpose To investigate and compare the anatomical success rates and complications of the treatment modalities for small saphenous Vein (SSV) incompetence. Methods A systematic literature search was performed in PubMed, EMBASE, and the Cochrane Library on the following therapies for incompetence of SSVs: surgery, endovenous laser ablation (EVLA), radiofrequency ablation (RFA), ultrasound-guided foam sclerotherapy (UGFS), steam ablation, and mechanochemical endovenous ablation (MOCA). The search found 49 articles (5 randomized controlled trials, 44 cohort studies) reporting on the different treatment modalities: surgery (n=9), EVLA (n=28), RFA (n=9), UGFS (n=6), and MOCA (n=1). A random-effects model was used to estimate the primary outcome of anatomical success, which was defined as closure of the treated Vein on follow-up duplex ultrasound imaging. The estimate is reported with the 95% confidence interval (CI). Secondary outcomes were technical success and major complications [paresthesia and deep Vein thrombosis (DVT)], given as the weighted means. Results The pooled anatomical success rate was 58.0% (95% CI 40.9% to 75.0%) for surgery in 798 SSVs, 98.5% (95% CI 97.7% to 99.2%) for EVLA in 2950 SSVs, 97.1% (95% CI 94.3% to 99.9%) for RFA in 386 SSVs, and 63.6% (95% CI 47.1% to 80.1%) for UGFS in 494 SSVs. One study reported results of MOCA, with an anatomical success rate of 94%. Neurologic complications were most frequently reported after surgery (mean 19.6%) and thermal ablation (EVLA: mean 4.8%; RFA: mean 9.7%). Deep venous thrombosis was a rare complication (0% to 1.2%). Conclusion Endovenous thermal ablation (EVLA/RFA) should be preferred to surgery and foam sclerotherapy in the treatment of SSV incompetence. Although data on nonthermal techniques in SSV are still sparse, the potential benefits, especially the reduced risk of nerve injury, might be of considerable clinical importance.
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Mechanochemical endovenous ablation versus radiofrequency ablation in the treatment of primary small saphenous Vein Insufficiency (MESSI trial): study protocol for a randomized controlled trial
Trials, 2014Co-Authors: Doeke Boersma, R.r.j.p. Van Eekeren, Debora A.b. Werson, Michel M.j.p. Reijnen, Suzanne Holewijn, Michiel A Schreve, Hans Kelder, Jean-paul P.m. De VriesAbstract:Background Minimally invasive endothermal techniques, for example, radiofrequency ablation (RFA), have revolutionized the treatment of insufficient truncal Veins and are associated with an excellent outcome. The use of thermal energy requires the instillation of tumescent anesthesia around the Vein. Mechanochemical endovenous ablation (MOCA™) combines mechanical endothelial damage, using a rotating wire, with simultaneous infusion of a liquid sclerosans. Tumescent anesthesia is not required as no heat is used. Prospective studies using MOCA™ in both great and small saphenous Veins showed good anatomical and clinical results with fast postoperative recovery.
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mechanochemical endovenous ablation versus radiofrequency ablation in the treatment of primary small saphenous Vein Insufficiency messi trial study protocol for a randomized controlled trial
Trials, 2014Co-Authors: Doeke Boersma, R.r.j.p. Van Eekeren, Debora A.b. Werson, Michel M.j.p. Reijnen, Suzanne Holewijn, Michiel A Schreve, Hans Kelder, Jean-paul P.m. De VriesAbstract:Minimally invasive endothermal techniques, for example, radiofrequency ablation (RFA), have revolutionized the treatment of insufficient truncal Veins and are associated with an excellent outcome. The use of thermal energy requires the instillation of tumescent anesthesia around the Vein. Mechanochemical endovenous ablation (MOCA™) combines mechanical endothelial damage, using a rotating wire, with simultaneous infusion of a liquid sclerosans. Tumescent anesthesia is not required as no heat is used. Prospective studies using MOCA™ in both great and small saphenous Veins showed good anatomical and clinical results with fast postoperative recovery. The MESSI trial (Mechanochemical Endovenous ablation versus radiofrequency ablation in the treatment of primary Small Saphenous Vein Insufficiency) is a multicenter randomized controlled trial in which a total of 160 patients will be randomized (1:1) to MOCA™ or RFA. Consecutive patients with primary small saphenous Vein incompetence, who meet the eligibility criteria, will be invited to participate in this trial. The primary endpoint is anatomic success, defined as occlusion of the treated Veins objectified with duplex ultrasonography at 1 year follow-up. Secondary endpoints are post-procedural pain, initial technical success, clinical success, complications and the duration of the procedure. Initial technical success is defined as the ability to position the device adequately, treat the Veins as planned and occlude the treated Vein directly after the procedure has been proven by duplex ultrasonography. Clinical success is defined as an objective improvement of clinical outcome after treatment, measured with the Venous Clinical Severity Score (VCSS). Power analyses are conducted for anatomical success and post-procedural pain. Both groups will be evaluated on an intention-to-treat principle. The hypothesis of the MESSI trial is that the anatomic success rate of MOCA™ is not inferior to RFA. The second hypothesis is that post-procedural pain is significantly less after MOCA compared to RFA. Trial registration: NTR4613 Date of trial registration: 28 May 2014.
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mechanochemical endovenous ablation for the treatment of great saphenous Vein Insufficiency
Journal of vascular surgery. Venous and lymphatic disorders, 2014Co-Authors: R.r.j.p. Van Eekeren, Doeke Boersma, Debora A.b. Werson, Jean-paul P.m. De Vries, Suzanne Holewijn, Michel M.j.p. ReijnenAbstract:Objective: This study evaluated the feasibility, safety, and 1-year results of mechanochemical endovenous ablation (MOCA) of great saphenous Vein (GSV) Insufficiency. Methods: A consecutive 106 patients were treated for primary GSV Insufficiency with MOCA by the ClariVein device and polidocanol. The primary outcome measures were technical success, clinical success, and anatomic success after 1 year of follow-up. Secondary outcome measures were postprocedural pain, complications, general- and disease-specific quality of life, and time to return to work. Patients were evaluated with clinical examination and duplex ultrasonography at 6 weeks, 6 months, and 1 year after treatment. Results: The technical success was 99%. The mean postprocedural pain during the first 14 days after treatment was 7.5 mm (interquartile range [IQR], 0.0-10.0 mm) per day on a 0- to 100-mm visual analog scale. The time to return to normal activities and work was 1.0 day (IQR, 0-1.0 day) and 1.0 day (IQR, 1.0-4.0 days), respectively. No major complications were recorded. At 1-year follow-up, the clinical success was 93%. The Venous Clinical Severity Score decreased significantly from 4.0 (IQR, 3.0-5.0) before treatment to 1.0 (IQR, 0-1.0) (P < .001) 1 year after MOCA. At 1 year, 88.2% of the treated GSVs remained occluded as measured by duplex ultrasonography. Twelve patients had a recanalization, of which eight were partial. Disease-specific quality of life and the RAND 36-Item Health Survey scores improved significantly at 1-year follow-up. Conclusions: MOCA is a safe and effective technique in the treatment of GSV Insufficiency with good clinical and anatomic success at 1-year follow-up. The technique is related to low postprocedural pain scores, low complication rate, improved quality of life, and rapid resumption of normal activities and work. (J Vasc Surg: Venous and Lym Dis 2014;2:282-8.)
R.r.j.p. Van Eekeren - One of the best experts on this subject based on the ideXlab platform.
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midterm outcome of mechanochemical endovenous ablation for the treatment of great saphenous Vein Insufficiency
Journal of Endovascular Therapy, 2017Co-Authors: Marianne E Witte, R.r.j.p. Van Eekeren, Jean-paul P.m. De Vries, Suzanne Holewijn, Clark J Zeebregts, Michel M.j.p. ReijnenAbstract:Purpose: To report the midterm results of mechanochemical ablation (MOCA) for treating great saphenous Vein (GSV) Insufficiency. Methods: In a 1-year period, 85 consecutive patients (median age 51....
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Treatment Modalities for Small Saphenous Vein Insufficiency: Systematic Review and Meta-analysis
Journal of endovascular therapy : an official journal of the International Society of Endovascular Specialists, 2015Co-Authors: Doeke Boersma, R.r.j.p. Van Eekeren, Michel M.j.p. Reijnen, Verena N. N. Kornmann, Ellen Tromp, Çağdaş Ünlü, Jean-paul P.m. De VriesAbstract:Purpose To investigate and compare the anatomical success rates and complications of the treatment modalities for small saphenous Vein (SSV) incompetence. Methods A systematic literature search was performed in PubMed, EMBASE, and the Cochrane Library on the following therapies for incompetence of SSVs: surgery, endovenous laser ablation (EVLA), radiofrequency ablation (RFA), ultrasound-guided foam sclerotherapy (UGFS), steam ablation, and mechanochemical endovenous ablation (MOCA). The search found 49 articles (5 randomized controlled trials, 44 cohort studies) reporting on the different treatment modalities: surgery (n=9), EVLA (n=28), RFA (n=9), UGFS (n=6), and MOCA (n=1). A random-effects model was used to estimate the primary outcome of anatomical success, which was defined as closure of the treated Vein on follow-up duplex ultrasound imaging. The estimate is reported with the 95% confidence interval (CI). Secondary outcomes were technical success and major complications [paresthesia and deep Vein thrombosis (DVT)], given as the weighted means. Results The pooled anatomical success rate was 58.0% (95% CI 40.9% to 75.0%) for surgery in 798 SSVs, 98.5% (95% CI 97.7% to 99.2%) for EVLA in 2950 SSVs, 97.1% (95% CI 94.3% to 99.9%) for RFA in 386 SSVs, and 63.6% (95% CI 47.1% to 80.1%) for UGFS in 494 SSVs. One study reported results of MOCA, with an anatomical success rate of 94%. Neurologic complications were most frequently reported after surgery (mean 19.6%) and thermal ablation (EVLA: mean 4.8%; RFA: mean 9.7%). Deep venous thrombosis was a rare complication (0% to 1.2%). Conclusion Endovenous thermal ablation (EVLA/RFA) should be preferred to surgery and foam sclerotherapy in the treatment of SSV incompetence. Although data on nonthermal techniques in SSV are still sparse, the potential benefits, especially the reduced risk of nerve injury, might be of considerable clinical importance.
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Mechanochemical endovenous ablation versus radiofrequency ablation in the treatment of primary small saphenous Vein Insufficiency (MESSI trial): study protocol for a randomized controlled trial
Trials, 2014Co-Authors: Doeke Boersma, R.r.j.p. Van Eekeren, Debora A.b. Werson, Michel M.j.p. Reijnen, Suzanne Holewijn, Michiel A Schreve, Hans Kelder, Jean-paul P.m. De VriesAbstract:Background Minimally invasive endothermal techniques, for example, radiofrequency ablation (RFA), have revolutionized the treatment of insufficient truncal Veins and are associated with an excellent outcome. The use of thermal energy requires the instillation of tumescent anesthesia around the Vein. Mechanochemical endovenous ablation (MOCA™) combines mechanical endothelial damage, using a rotating wire, with simultaneous infusion of a liquid sclerosans. Tumescent anesthesia is not required as no heat is used. Prospective studies using MOCA™ in both great and small saphenous Veins showed good anatomical and clinical results with fast postoperative recovery.
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mechanochemical endovenous ablation versus radiofrequency ablation in the treatment of primary small saphenous Vein Insufficiency messi trial study protocol for a randomized controlled trial
Trials, 2014Co-Authors: Doeke Boersma, R.r.j.p. Van Eekeren, Debora A.b. Werson, Michel M.j.p. Reijnen, Suzanne Holewijn, Michiel A Schreve, Hans Kelder, Jean-paul P.m. De VriesAbstract:Minimally invasive endothermal techniques, for example, radiofrequency ablation (RFA), have revolutionized the treatment of insufficient truncal Veins and are associated with an excellent outcome. The use of thermal energy requires the instillation of tumescent anesthesia around the Vein. Mechanochemical endovenous ablation (MOCA™) combines mechanical endothelial damage, using a rotating wire, with simultaneous infusion of a liquid sclerosans. Tumescent anesthesia is not required as no heat is used. Prospective studies using MOCA™ in both great and small saphenous Veins showed good anatomical and clinical results with fast postoperative recovery. The MESSI trial (Mechanochemical Endovenous ablation versus radiofrequency ablation in the treatment of primary Small Saphenous Vein Insufficiency) is a multicenter randomized controlled trial in which a total of 160 patients will be randomized (1:1) to MOCA™ or RFA. Consecutive patients with primary small saphenous Vein incompetence, who meet the eligibility criteria, will be invited to participate in this trial. The primary endpoint is anatomic success, defined as occlusion of the treated Veins objectified with duplex ultrasonography at 1 year follow-up. Secondary endpoints are post-procedural pain, initial technical success, clinical success, complications and the duration of the procedure. Initial technical success is defined as the ability to position the device adequately, treat the Veins as planned and occlude the treated Vein directly after the procedure has been proven by duplex ultrasonography. Clinical success is defined as an objective improvement of clinical outcome after treatment, measured with the Venous Clinical Severity Score (VCSS). Power analyses are conducted for anatomical success and post-procedural pain. Both groups will be evaluated on an intention-to-treat principle. The hypothesis of the MESSI trial is that the anatomic success rate of MOCA™ is not inferior to RFA. The second hypothesis is that post-procedural pain is significantly less after MOCA compared to RFA. Trial registration: NTR4613 Date of trial registration: 28 May 2014.
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mechanochemical endovenous ablation for the treatment of great saphenous Vein Insufficiency
Journal of vascular surgery. Venous and lymphatic disorders, 2014Co-Authors: R.r.j.p. Van Eekeren, Doeke Boersma, Debora A.b. Werson, Jean-paul P.m. De Vries, Suzanne Holewijn, Michel M.j.p. ReijnenAbstract:Objective: This study evaluated the feasibility, safety, and 1-year results of mechanochemical endovenous ablation (MOCA) of great saphenous Vein (GSV) Insufficiency. Methods: A consecutive 106 patients were treated for primary GSV Insufficiency with MOCA by the ClariVein device and polidocanol. The primary outcome measures were technical success, clinical success, and anatomic success after 1 year of follow-up. Secondary outcome measures were postprocedural pain, complications, general- and disease-specific quality of life, and time to return to work. Patients were evaluated with clinical examination and duplex ultrasonography at 6 weeks, 6 months, and 1 year after treatment. Results: The technical success was 99%. The mean postprocedural pain during the first 14 days after treatment was 7.5 mm (interquartile range [IQR], 0.0-10.0 mm) per day on a 0- to 100-mm visual analog scale. The time to return to normal activities and work was 1.0 day (IQR, 0-1.0 day) and 1.0 day (IQR, 1.0-4.0 days), respectively. No major complications were recorded. At 1-year follow-up, the clinical success was 93%. The Venous Clinical Severity Score decreased significantly from 4.0 (IQR, 3.0-5.0) before treatment to 1.0 (IQR, 0-1.0) (P < .001) 1 year after MOCA. At 1 year, 88.2% of the treated GSVs remained occluded as measured by duplex ultrasonography. Twelve patients had a recanalization, of which eight were partial. Disease-specific quality of life and the RAND 36-Item Health Survey scores improved significantly at 1-year follow-up. Conclusions: MOCA is a safe and effective technique in the treatment of GSV Insufficiency with good clinical and anatomic success at 1-year follow-up. The technique is related to low postprocedural pain scores, low complication rate, improved quality of life, and rapid resumption of normal activities and work. (J Vasc Surg: Venous and Lym Dis 2014;2:282-8.)
Suzanne Holewijn - One of the best experts on this subject based on the ideXlab platform.
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midterm outcome of mechanochemical endovenous ablation for the treatment of great saphenous Vein Insufficiency
Journal of Endovascular Therapy, 2017Co-Authors: Marianne E Witte, R.r.j.p. Van Eekeren, Jean-paul P.m. De Vries, Suzanne Holewijn, Clark J Zeebregts, Michel M.j.p. ReijnenAbstract:Purpose: To report the midterm results of mechanochemical ablation (MOCA) for treating great saphenous Vein (GSV) Insufficiency. Methods: In a 1-year period, 85 consecutive patients (median age 51....
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Mechanochemical endovenous ablation versus radiofrequency ablation in the treatment of primary small saphenous Vein Insufficiency (MESSI trial): study protocol for a randomized controlled trial
Trials, 2014Co-Authors: Doeke Boersma, R.r.j.p. Van Eekeren, Debora A.b. Werson, Michel M.j.p. Reijnen, Suzanne Holewijn, Michiel A Schreve, Hans Kelder, Jean-paul P.m. De VriesAbstract:Background Minimally invasive endothermal techniques, for example, radiofrequency ablation (RFA), have revolutionized the treatment of insufficient truncal Veins and are associated with an excellent outcome. The use of thermal energy requires the instillation of tumescent anesthesia around the Vein. Mechanochemical endovenous ablation (MOCA™) combines mechanical endothelial damage, using a rotating wire, with simultaneous infusion of a liquid sclerosans. Tumescent anesthesia is not required as no heat is used. Prospective studies using MOCA™ in both great and small saphenous Veins showed good anatomical and clinical results with fast postoperative recovery.
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mechanochemical endovenous ablation versus radiofrequency ablation in the treatment of primary small saphenous Vein Insufficiency messi trial study protocol for a randomized controlled trial
Trials, 2014Co-Authors: Doeke Boersma, R.r.j.p. Van Eekeren, Debora A.b. Werson, Michel M.j.p. Reijnen, Suzanne Holewijn, Michiel A Schreve, Hans Kelder, Jean-paul P.m. De VriesAbstract:Minimally invasive endothermal techniques, for example, radiofrequency ablation (RFA), have revolutionized the treatment of insufficient truncal Veins and are associated with an excellent outcome. The use of thermal energy requires the instillation of tumescent anesthesia around the Vein. Mechanochemical endovenous ablation (MOCA™) combines mechanical endothelial damage, using a rotating wire, with simultaneous infusion of a liquid sclerosans. Tumescent anesthesia is not required as no heat is used. Prospective studies using MOCA™ in both great and small saphenous Veins showed good anatomical and clinical results with fast postoperative recovery. The MESSI trial (Mechanochemical Endovenous ablation versus radiofrequency ablation in the treatment of primary Small Saphenous Vein Insufficiency) is a multicenter randomized controlled trial in which a total of 160 patients will be randomized (1:1) to MOCA™ or RFA. Consecutive patients with primary small saphenous Vein incompetence, who meet the eligibility criteria, will be invited to participate in this trial. The primary endpoint is anatomic success, defined as occlusion of the treated Veins objectified with duplex ultrasonography at 1 year follow-up. Secondary endpoints are post-procedural pain, initial technical success, clinical success, complications and the duration of the procedure. Initial technical success is defined as the ability to position the device adequately, treat the Veins as planned and occlude the treated Vein directly after the procedure has been proven by duplex ultrasonography. Clinical success is defined as an objective improvement of clinical outcome after treatment, measured with the Venous Clinical Severity Score (VCSS). Power analyses are conducted for anatomical success and post-procedural pain. Both groups will be evaluated on an intention-to-treat principle. The hypothesis of the MESSI trial is that the anatomic success rate of MOCA™ is not inferior to RFA. The second hypothesis is that post-procedural pain is significantly less after MOCA compared to RFA. Trial registration: NTR4613 Date of trial registration: 28 May 2014.
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mechanochemical endovenous ablation for the treatment of great saphenous Vein Insufficiency
Journal of vascular surgery. Venous and lymphatic disorders, 2014Co-Authors: R.r.j.p. Van Eekeren, Doeke Boersma, Debora A.b. Werson, Jean-paul P.m. De Vries, Suzanne Holewijn, Michel M.j.p. ReijnenAbstract:Objective: This study evaluated the feasibility, safety, and 1-year results of mechanochemical endovenous ablation (MOCA) of great saphenous Vein (GSV) Insufficiency. Methods: A consecutive 106 patients were treated for primary GSV Insufficiency with MOCA by the ClariVein device and polidocanol. The primary outcome measures were technical success, clinical success, and anatomic success after 1 year of follow-up. Secondary outcome measures were postprocedural pain, complications, general- and disease-specific quality of life, and time to return to work. Patients were evaluated with clinical examination and duplex ultrasonography at 6 weeks, 6 months, and 1 year after treatment. Results: The technical success was 99%. The mean postprocedural pain during the first 14 days after treatment was 7.5 mm (interquartile range [IQR], 0.0-10.0 mm) per day on a 0- to 100-mm visual analog scale. The time to return to normal activities and work was 1.0 day (IQR, 0-1.0 day) and 1.0 day (IQR, 1.0-4.0 days), respectively. No major complications were recorded. At 1-year follow-up, the clinical success was 93%. The Venous Clinical Severity Score decreased significantly from 4.0 (IQR, 3.0-5.0) before treatment to 1.0 (IQR, 0-1.0) (P < .001) 1 year after MOCA. At 1 year, 88.2% of the treated GSVs remained occluded as measured by duplex ultrasonography. Twelve patients had a recanalization, of which eight were partial. Disease-specific quality of life and the RAND 36-Item Health Survey scores improved significantly at 1-year follow-up. Conclusions: MOCA is a safe and effective technique in the treatment of GSV Insufficiency with good clinical and anatomic success at 1-year follow-up. The technique is related to low postprocedural pain scores, low complication rate, improved quality of life, and rapid resumption of normal activities and work. (J Vasc Surg: Venous and Lym Dis 2014;2:282-8.)
George Carchedi Luccas - One of the best experts on this subject based on the ideXlab platform.
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Comparison of endovenous treatment with an 810 nm laser versus conventional stripping of the great saphenous Vein in patients with primary varicose Veins
Canadá, 2015Co-Authors: De Medeiros Caf, George Carchedi LuccasAbstract:BACKGROUND. Patients with varicose Veins seek medical assistance for many reasons, including esthetic ones. The development of suitable and more flexible instruments, along with less invasive techniques, enables the establishment of new therapeutic procedures. OBJECTIVE. To compare endovenous great saphenous Vein photocoagulation with an 810 nm diode laser and the conventional stripping operation in the same patient. METHODS. Twenty patients selected for operative treatment of primary great saphenous Vein Insufficiency on duplex scanning were assigned to a bilateral random comparison. In all cases, both techniques were performed, one on each lower limb. Clinically, evaluation was assessed on the seventh, thirtieth, and sixtieth postoperative days. Patients underwent examination with duplex ultrasonography and air plethysmography during the follow-up. RESULTS. Patients who received endovenous photocoagulation presented with the same pain but fewer swellings and less bruising than the stripping side. Most patients indicated that the limb operated on by laser received more benefits than the other. There was only one recanalization and no adverse effects. The venous filling time showed better hemodynamics in both techniques. CONCLUSION. The endovenous great saphenous Vein photocoagulation is safe and well tolerated and presents results comparable to those of conventional stripping.31121685169
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comparison of endovenous treatment with an 810 nm laser versus conventional stripping of the great saphenous Vein in patients with primary varicose Veins
Dermatologic Surgery, 2005Co-Authors: Charles Angotti Furtado De Medeiros, George Carchedi LuccasAbstract:Background. Patients with varicose Veins seek medical assistance for many reasons, including esthetic ones. The development of suitable and more flexible instruments, along with less invasive techniques, enables the establishment of new therapeutic procedures. Objective. To compare endovenous great saphenous Vein photocoagulation with an 810 nm diode laser and the conventional stripping operation in the same patient. Methods. Twenty patients selected for operative treatment of primary great saphenous Vein Insufficiency on duplex scanning were assigned to a bilateral random comparison. In all cases, both techniques were performed, one on each lower limb. Clinically, evaluation was assessed on the seventh, thirtieth, and sixtieth postoperative days. Patients underwent examination with duplex ultrasonography and air plethysmography during the follow-up. Results. Patients who received endovenous photocoagulation presented with the same pain but fewer swellings and less bruising than the stripping side. Most patients indicated that the limb operated on by laser received more benefits than the other. There was only one recanalization and no adverse effects. The venous filling time showed better hemodynamics in both techniques. Conclusion. The endovenous great saphenous Vein photocoagulation is safe and well tolerated and presents results comparable to those of conventional stripping. CHARLES ANGOTTI FURTADO DE MEDEIROS, MSC, AND GEORGE CARCHEDI LUCCAS, PHD, HAVE INDICATED NO SIGNIFICANT INTEREST WITH COMMERCIAL SUPPORTERS.
