Mechano-chemical ablation of saphenous veins is a minimally invasive procedure developed to minimize negative aspects of endothermal ablation and ultrasound guided sclerotherapy, while incorporating the benefits of each.
The setup for mechano-chemical ablation is very simple: micropuncture set, catheter with the rotating wire, motorized handle unit, syringe for the infusion of the liquid sclerosant.
A percutaneous venous access under ultrasound guidance allows the positioning of a 4Fr introducer sheath.
Vein occlusion is achieved utilizing a rotating wire running through the catheter lumen, which abrades the inner wall of the vein, creating venospasm; a liquid sclerosant is simultaneously infused through an opening at the distal end of the catheter. These 2 modalities provide venous occlusion results equal to endothermal methods and superior to ultrasound guided sclerotherapy.
The system doesn’t use thermal energy, so there’s no need for tumescent anesthesia along the course of the vein, and the vein can be treated over its full length without concern for thermal injury to nerve, skin or muscle.
The elimination of tumescent infusion decreases patient discomfort while shortening procedure time.
The catheter is placed through the sheath and pushed up to the saphenofemoral junction under ultrasound guidance.
The wire tip is positioned 2 cm from the sapheno-femoral junction, the wire rotation is activated for 2-3 sec prior starting the infusion of the sclerosant agent, the catheter is then slowly withdrawn at a rate of approximately 1.5-2 mm/sec.
After the catheter has been removed, the surgeon checks for saphenous vein occlusion using ultrasound.
At the end of the procedure, patient is encouraged to walk immediately and to resume normal day activities.