Catheter sclerotherapy

Mechanochemical endovenous ablation

A specific variant of catheter sclerotherapy is the so-called  mechano-chemical vein ablation (MOCA). This technique, developed since the beginning of the 21st century, combines the chemical action of a sclerosant with mechanical damage to the vein endothelium, which increases the effectiveness of the procedure. MOCA utilizes special" catheter systems. The most widespread are: Flebogrif and Clarivein, which, through their unique mechanisms of action – rotating elements or hooks – mechanically damage the inner wall of the vessel, facilitating the penetration of the sclerosant and the closure of the vein lumen.

Flebogrif is a system that has gained popularity due to its versatility and safety, while Clarivein is known for its effectiveness and minimal invasiveness. The mechanism of action of MOCA is based on the simultaneous irritation and damage of the vascular endothelium, vasoconstrictive action, and simultaneous administration of foamed sclerosant. Compared to thermal ablation (laser – EVLA or using radiofrequency waves – EVRF), MOCA is less painful and often does not require tumescent anesthesia, unless we use it to reduce the lumen of the vessel being ablated.

The effectiveness of catheter sclerotherapy, including MOCA, has been confirmed in numerous studies. However, it remains quite high only in the first 2 years after the procedure. It decreases later on, which is why at the Phlebology Clinic, we prefer thermal ablation methods, such as endovenous laser ablation using the ELVeS. Our many years of research show that this is a much more effective treatment."

This does not change the fact that catheter sclerotherapy is a safe and quite effective method, also cheaper than thermoablative methods. and certainly provides an alternative to traditional varicose vein treatment methods.

What can be treated using catheter sclerotherapy?

Catheter sclerotherapy has a fairly wide range of applications in the treatment of venous insufficiency, including the treatment of pelvic venous insufficiency (where we use certain modifications of it). At the Phlebology Clinic, we most often use it to treat:

• truncal venous insufficiency
• varicose veins of the lower extremities;
• recurrent venous disease
• varicose veins located in hard-to-reach areas;
• pelvic venous insufficiency and secondary parametrial varices;
• venous malformations.

Price range

Description of the catheter sclerotherapy procedure

The catheter sclerotherapy procedure at the Phlebology Clinic follows the following scheme:

• phlebological consultation and Doppler ultrasound examination for treatment qualification – The Patient is qualified for the procedure based on the medical history, physical examination, and Doppler ultrasound examination of the veins;
• preparation: the skin at the puncture site is disinfected, and the Patient is positioned to allow access to the vein being treated;
• anesthesia: local anesthesia is used as needed; vascular access is established under ultrasound guidance using a modified Seldinger technique

Post-foam sclerotherapy care

After the foam sclerotherapy procedure, the Patient should strictly follow the phlebologist's recommendations. Recommendations following sclerotherapy procedures include:

• brisk walking – immediately after the procedure, a short but brisk walk lasting approximately 30-40 minutes is recommended;
• wearing compression garments – compression stockings or pantyhose should be worn for 7-14 days after the procedure (always follow the doctor's recommendations);
• avoiding overheating – during the recovery period, it is advisable to avoid saunas, tanning beds, and hot baths, as well as excessive exposure to sunlight;
• avoiding strenuous physical activity for approximately 7-10 days after the procedure.

In case of any disturbing symptoms (e.g., severe pain, swelling, redness), you should immediately contact the phlebologist who performed the procedure.

Complications after catheter sclerotherapy

Catheter sclerotherapy is a safe treatment method, but like any medical procedure, it carries a certain risk of complications.
The most common complications and side effects associated with the catheter sclerotherapy procedure and its MOCA modification include:

• bruising and pain at the injection site;
• skin discoloration along the course of the obliterated varicose vein;
• superficial thrombophlebitis;
• thickening at the site of the obliterated vein (a temporary phenomenon);

Much less frequently occurring are:

• deep vein thrombosis
• allergic reactions;
• neurological complications (e.g., headaches, visual disturbances, transient weakness);
• skin necrosis

At the Phlebology Clinic we make every effort to minimise the risk of complications and our specialists remain available to patients during the recovery period. If you experience any worrying symptoms, please contact our Registry immediately.