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Chapters
Introduction Disclosures Categories
Introduction Disclosures Categories
2017Charing CrossClariVeinnoindextechnologyupdateVascular Insightsvenous
MOCA: ClariVein Rotating Wire Tip Device - Liquid Sclerosant Injection
MOCA: ClariVein Rotating Wire Tip Device - Liquid Sclerosant Injection
2017bloodCharing CrossClariVeindilatednoindexocclusionrotatingsclerosingVascular Insightsveinwire
Technology & Techniques - Outcomes of MOCA
Technology & Techniques - Outcomes of MOCA
2017Charing CrossClariVeincompareddiseaseinjuryintraproceduralnoindexocclusionradiofrequencyscoresshortertechniqueVascular Insightsvenous
How does it work? - Histologic Analysis of Vessel Wall with MOCA or Sclerosant
How does it work? - Histologic Analysis of Vessel Wall with MOCA or Sclerosant
2017Charing CrossClariVeindisclosuremedialminutesnoindexoccludedVascular Insightsweeks
MOCA Lessons
MOCA Lessons
2017ablationCharing CrossClariVeindamageendothelialmedianoindexocclusionsclerosingtumescentVascular Insights
Transcript

It gives me great pleasure call...to stages genuinely one of the giants in the treatment of venous disease and...mean that's ... Thank younot at all but okay, ...you've heard during this session already all of the non-thermal non-tumescent at technologies that are really coming into play I'm...a little bit about really updating the original non-thermal non-tumescent technology ...or...clarivein that we really did the original study back

...twenty-nine so this is a significant amount of data that's come up so I want kind of bring you up-to-date these are my disclosures. And, you know,...for an update I have to tell you something maybe tell you one sb tell me something that's new tell me something I don't know highlight what I do know but, don't just tell me what I already know and I and I hope that this talk is going to get

you there so there's a couple different categories of the update one is a technology technique...over the some recent literature...disclosures been around now since the twenty-fifth twenty nine two thousand ten and I'll give you some updates in terms of what the venous societies and the government guidelines have evolve to so

devices a rotating wire at the end of this device... do this do we need that and thing...

There's a rotating wire at the end of the device that goes around ...thirty five hundred revolutions per minute and then a ...sclerosis and is injected as the wires going round and round? Dust and going to conclude the occlusion so it combines it really was developed to minimize the in the thermal...negative aspects of ...the thermal and slower therapy but incorporating the benefits of each of them.

Comes in different lengths forty-five sixty-five and ...and that's kind of important as we talk about getting doubt all the way down to the angle. So, here's the tip here that breaks down the blood ...between the blood and the surface tension...the blood in the vein wall sclerosing comes out here the wire takes up the sclerosing and the...leaves the tip like a...

the right into the vein wall itself and this is just a wire rotating around. Here's what's really happening...spasm...been treated so it's not a dilated vein that's what I think...some of the benefits as well so in terms

of the technology technique there's really been no major changes but the real changes ...terms of the technique which is we now realize you could go all the way down to the angle...to disease process goes down to the

ankle without having to worry about nerve injury or skin injury and that's a real benefit of the non-thermal non-tumescent so if you have disease below the ...you have advanced disease with...damascus roses very hard to put to messes in that area here you can do it also shortly compression to just the twenty-four hours myself this is really what's been out there in the a literature you could see there's been good follow-up with a narrow down on a lot of these but,

occlusion racer in the...nineties mid-nineties to height eighty so again the really comparable to what we already have out there and I'm going to show you two studies that compared to rf talked about how they returned to work and the at minimum is really not been many adverse events at all ...this slide highlights is it's relatively safe compared to the others very low...reported rate and here you can see

that really that occlusion rates are all the comparable. Ok, so, let's...down from some of the more recent studies that have been done this is a assessing intraprocedural ... ...compared to radiofrequency which we've already know is less painful than laser so it's compared to the gold standard in terms of

...techniques and ...study...by...shows that whims ...divided and during the procedure edit one month and you can see here that thepain scores based on one hundred were much less with the carving devices as compared to the radiofrequency device and that was quite that was significant time to return to normal activities

and time to return to work with shorter with the clarivein as well and the complication rates were really none for clarivein just this ...for the radiofrequency now this is comparing ...final results of the truck...rf to carving and one month the closure rate was really basically the same there was no difference and we already had heard that if a vein is closed quality of life scores all into...doesn't matter how you

closes if it's close quality of life scores improve and, here to this the actions that so once again here's some of the key results the venous clinical severity scores improved the pain scores were much lower in terms of clarivein ...postoperatively and also at fourteen days very significantly lower as well and returns activity was a shorter so pretty

nice things now how does this thing work ok we kinda figure out...how it worked but there's to

do elegance studies that are in the literature recently one was done with...and lateral ...and it was divided to groups at forty five minutes everybody got eithermoca just mechanical...just disclosure aspect gate and the harvested...minutes and six weeks and forty five minutes the moca and, the mechanical were occluded disclosure was already open after forty five minutes

...treatment but more importantly at six weeks moca was the only one that was included the others open so you can just do the mechanical...just do the ...is to combination that really adds to it also of interest is at six weeks and this is going to be a theme...see in the next one was medial damage yes but more important was at intentional damage...already heard the allusion to ...rightly...last time so mark white we did and I study again,

...range treating them with moca just mechanical just...and, what he found was that was increase penetration of the sclerosing with the ...mechanical in the chemical is endothelial damage but there was also damage to the media and this is the key to keeping a vein close you need to damage the media as well a lot of cases been done throughout the world the occlusion rate is really comparable with the literature that's not very

mature for the clouding device compares relative...thermal tumescent less pain ...rate really low quality of life...tells it we now have a good idea about how this thing works there is a code in the us and the major society's both ...and uk nicer now...as another alternative ...so we didn't have much in the year late nineties we now have a lot to use as my feeling that the future of non-thermal ablation is also the future of

intervenes ablation thank you.

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