Five Year Follow Up of Mechanochemical Ablation for the Treatment of Small Saphenous Vein Incompetence
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Updated: Mar 20, 2026
Occlusion of the Great and Small Saphenous Vein Using Copolymeric Glue Based on N-Butyl Cyanoacrylate and Methacryloxy Sulfolane
Published on: December 9, 2022
Domenico Baccellieri1, Vincenzo Ardita1, Ferdinando B A Valente1
1Vein Centre, Vascular Surgery Unit, IRCCS San Raffaele Scientific Institute, Milan, Italy; Vita-Salute San Raffaele University, Milan, Italy.
Objective:
The aim of this study was to assess the effectiveness of mechanochemical ablation (MOCA) for the treatment of small saphenous vein (SSV) incompetence at 3 and 5 years, building on preliminary results that showed feasibility, safety, and high occlusion rates at 1 year follow up.
Methods:
Sixty patients who underwent MOCA for SSV incompetence at a single centre between January 2017 and December 2019 were included. Clinical and radiological data were reviewed retrospectively from a prospectively maintained database. Primary endpoints were SSV recanalisation and re-intervention at 3 and 5 years. Additional outcome measures included Venous Clinical Severity Score (VCSS), quality of life (QoL) using the Aberdeen Varicose Vein Questionnaire (AVVQ) and the visual analogue scale to assess pain during long term follow up, and signs and symptoms of chronic venous disease. Uni- and multivariable analyses were performed to identify risk factors for SSV recanalisation.
Results:
Fifty patients completed the full 5 year follow up. Freedom from recanalisation was 84.7% at 3 years and 66.5% at 5 years. Freedom from re-intervention at the same time points was 86.7% and 72.6%, respectively. Although the VCSS and AVVQ scores decreased during the first year, a progressive increase was observed over the follow up period. The median VCSS increased significantly at 3 and 5 years. The AVVQ score increased from a median (interquartile range [IQR]) of 5.0 (IQR 3.0, 7.0) at 1 year to 8.2 (IQR 5.0, 11.0) at 3 years and 10.1 (IQR 6.0, 14.0) at 5 years (p < .001). Multivariable analysis identified body mass index > 25 kg/m2 and pre-operative SSV diameter > 6 mm as significant risk factors for SSV recanalisation.
Conclusion:
Treatment of SSV incompetence with MOCA had high 5 year recanalisation and re-intervention rates. Additionally, a progressive decrease in QoL and deterioration of patient reported outcomes over time were found, as reflected by rising VCSS and AVVQ scores.
