Researchers Mark Steven Whiteley, Jaya L Nemchand, Roberto M La Ragione, and David Beckett have recently published a study in the College of Phlebology Preprints, examining the potential of the Clarivein® device in treating pelvic vein reflux. The study utilized an ovine model to evaluate the efficacy of this non-implantable device in addressing truncal pelvic vein reflux, a common cause of symptomatic venous disorders. The findings provide important insights into the limitations of using Clarivein® for pelvic varicosities while suggesting potential applications in treating retroperitoneal veins.
The researchers conducted the study using a freshly euthanized female adult sheep (ewe) as the ovine model. During the post-mortem examination, the ovarian veins were identified on both sides of the sheep. The Clarivein® catheter was inserted directly into the proximal portions of the right and left ovarian veins, followed by caudal passage. Activation of the device was followed by a controlled withdrawal at a rate of 7 seconds per centimetre. For comparative analysis, a nearby retroperitoneal mesenteric vein was also treated using the same methodology.
The study’s results revealed interesting observations regarding the behaviour of the Clarivein® device. In the ewe model, the distal ovarian veins, located within peritoneal folds similar to the human broad ligament, lacked sufficient supporting tissue. As a result, when the wire tip was rotated, the veins became entangled and ensnared the device. However, retroperitoneal veins situated directly on the posterior abdominal wall allowed smooth rotation of the wire without any entanglement.
Based on these findings, the researchers concluded that the effectiveness of the Clarivein® device relies on the presence of adequate supporting tissue in the targeted vein. The unsupported nature of pelvic veins within peritoneal folds makes them prone to entanglement, limiting the device’s suitability for treating pelvic varicosities. However, the device may hold promise in treating retroperitoneal veins that are held against the abdominal or pelvic wall by the parietal peritoneum.
These findings contribute to a better understanding of the potential applications and limitations of the Clarivein® device in addressing pelvic vein reflux. Healthcare professionals can use this information to make informed decisions when considering treatment options for patients. However, it is important to note that the study was conducted using an ovine model, and further research is needed to validate these findings in human subjects.
By exploring alternative non-implantable methods of treating pelvic vein reflux, these findings encourage ongoing research efforts in the field. Future studies can build upon these insights to develop improved approaches for managing this common venous disorder.