English Polski
Vol 24, No 3 (2018)
Published online: 2018-10-25

open access

Page views 1544
Article views/downloads 1303
Get Citation

Connect on Social Media

Connect on Social Media

A new device for minimally invasive mechano-chemical method of saphenous vein ablation. Report of 12 months of follow up

Marek Iłżecki1, Piotr Terlecki1, Stanisław Przywara1, Tomasz Urbanek2, Agnieszka Pedrycz-Wieczorska3, Shawn Dave4, Tomasz Zubilewicz1
Acta Angiologica 2018;24(3):70-73.


Introduction. The purpose of the study was to assess the effectiveness of endovascular mechanochemical
ablation of the Great Saphenous vein and the Small Saphenous vein (GSV/SSV) using the use of Flebogrif®
catheter and method, based on results obtained from the analysis of 200 patients.

Material and methods. 200 patients underwent mechanochemical ablation using the Flebogrif® technique,
of the 200 patients, 172 patients experienced insufficiency of the GSV and 28 experienced insufficiencies of
the SSV. Follow-up assessment was established by outpatient appointments at 1, 3, 6, and 12 months postoperatively.
During each subsequent visit, the result of the procedure was evaluated with the use of ultrasound.
Furthermore, the intensity of clinical manifestations was assessed with the use of VCSS, CEAP, VASP scales. Any
complications were also noted.

Results. During 12-month follow-up the number of participants decreased to 168 (152 female, 16 male).
Complete closure of the vein was achieved in 154 patients (140 female, 14 male). According to adopted
criteria, 15 cases of recanalization were detected (10 complete and 5 partial). Based on the obtained results
the effectiveness of the method was assessed at 92%.

Conclusions. The statistical analysis of the 12-month follow-up data allowed us to conclude the following the
procedural method had 92% of effectiveness at 12-month follow-up, vein diameter was not a significant limitation
for the application of the technique, there was a low rate of serious complications, and adverse cosmetic effect
was minimal. However , the method requires further long-term follow-up to allow for a complete assessment.

Article available in PDF format

View PDF Download PDF file


  1. Kiguchi MM, Dillavou ED. Thermal and nonthermal endovenous ablation options for treatment of superficial venous insufficiency. Surg Clin North Am. 2018; 98(2): 385–400.
  2. van Eekeren RR, Boersma D, de Vries JPPM, et al. Update of endovenous treatment modalities for insufficient saphenous veins — a review of literature. Semin Vasc Surg. 2014; 27(2): 118–136.
  3. Leopardi D, Hoggan BL, Fitridge RA, et al. Systematic review of treatments for varicose veins. Ann Vasc Surg. 2009; 23(2): 264–276.
  4. van Eekeren RR, Boersma D, Elias S, et al. Endovenous mechanochemical ablation of great saphenous vein incompetence using the ClariVein device: a safety study. J Endovasc Ther. 2011; 18(3): 328–334.
  5. van den Bos RR, de Maeseneer M. Endovenous thermal ablation for varicose veins: strengths and weaknesses. Phlebolymphology. 2012; 19(4): 163–169.
  6. Kurdal AT, Yildirim F, Ozbakkaloglu A, et al. Ultrasound-guided catheter-directed foam sclerotherapy for great saphenous vein. Minerva Chir. 2015; 70(1): 33–36.
  7. Göckeritz O. Current standards and recent progress in minimally invasive phlebo surgery. J Cutan Aesthet Surg. 2012; 5(2): 104–114.
  8. Elias S, Raines JK. Mechanochemical tumescentless endovenous ablation: final results of the initial clinical trial. Phlebology. 2012; 27(2): 67–72.
  9. Rabe E, Breu FX, Cavezzi A, et al. Guideline Group. European guidelines for sclerotherapy in chronic venous disorders. Phlebology. 2014; 29(6): 338–354.
  10. Vun SV, Rashid ST, Blest NC, et al. Lower pain and faster treatment with mechanico-chemical endovenous ablation using ClariVein®. Phlebology. 2015; 30(10): 688–692.
  11. Niedzwiecki G. Endovenous thermal ablation of the saphenous vein. Semin Intervent Radiol. 2005; 22(3): 204–208.
  12. van Eekeren RR, Boersma D, Elias S, et al. Endovenous mechanochemical ablation of great saphenous vein incompetence using the ClariVein device: a safety study. J Endovasc Ther. 2011; 18(3): 328–334.
  13. Badri H, Bhattacharya V. A review of current treatment strategies for varicose veins. Recent Pat Cardiovasc Drug Discov. 2008; 3(2): 126–136.
  14. Bootun R, Lane TRA, Dharmarajah B, et al. Intra-procedural pain score in a randomised controlled trial comparing mechanochemical ablation to radiofrequency ablation: The Multicentre Venefit™ versus ClariVein® for varicose veins trial. Phlebology. 2016; 31(1): 61–65.
  15. Milleret R, Huot L, Nicolini P, et al. Great saphenous vein ablation with steam injection: results of a multicentre study. Eur J Vasc Endovasc Surg. 2013; 45(4): 391–396.
  16. Ciostek P, Kowalski M, Woźniak W, et al. Phlebogriffe — a new device for mechanochemical ablation of incompetent saphenous veins: a pilot study. Phlebological Review. 2015; 3: 72–77.
  17. Nijsten T, van den Bos RR, Goldman MP, et al. Minimally invasive techniques in the treatment of saphenous varicose veins. J Am Acad Dermatol. 2009; 60(1): 110–119.
  18. Witte ME, Reijnen MM, de Vries JP, et al. Mechanochemical Endovenous Occlusion of Varicose Veins Using the ClariVein® Device. Surg Technol Int. 2015; 26: 219–225.
  19. Zubilewicz T, Terlecki P, Przywara S, et al. Applications of mechanochemical ablation with Flebogrif to treat varicose veins of lower extrmities: a single center experience over 3 months observation. Acta Angiol. 2006; 22(4): 137–142.
  20. Vos CG, Ünlü Ç, Bosma J, et al. A systematic review and meta-analysis of two novel techniques of nonthermal endovenous ablation of the great saphenous vein. J Vasc Surg Venous Lymphat Disord. 2017; 5(6): 880–896.