Mechanochemical Ablation: Current Status in the Management of Varicose Veins: A Comprehensive Review

Abstract

Varicose veins, a common venous disorder, often lead to significant discomfort and a reduced quality of life. Over the years, numerous treatment approaches have been explored to alleviate the associated symptoms. Surgical interventions such as saphenofemoral junction ligation and Great Saphenous Vein (GSV) stripping were transformative in their time, but the emergence of endovenous techniques like Endovenous Laser Therapy (EVLT) and Radiofrequency Ablation (RFA) marked a significant shift. While these endovenous techniques have shown exceptional clinical outcomes and cost-effectiveness, they do come with the drawback of pain due to the application of heat for ablation and the necessity of infiltrating tumescent anaesthesia around the vein. In recent years, non thermal, non tumescent methods have arisen as effective alternatives that reduce patient discomfort. These methods encompass procedures such as Mechanochemical Ablation (MOCA) and endovenous cyanoacrylate glue, which minimise heat generation and eliminate the need for tumescent anaesthesia. This article provides a comprehensive overview of the current status of MOCA. It covers its mechanism of action, clinical outcomes, cost-effectiveness, and safety profiles in managing varicose veins.