In a recent study published in the British Journal of Surgery- BJS, a team of researchers from the Department of Vascular Surgery at Hull University Teaching Hospitals investigated the clinical outcomes of Mechanochemical Ablation (MOCA) compared to the conventional method of treatment, Endovenous Thermal Ablation (EVTA), for superficial venous incompetence. The study, led by Arthur J M Lim, Abduraheem H Mohamed, Louise H Hitchman, Ross Lathan, Bharadhwaj Ravindhran, Misha M Sidapra, George Smith, Ian C Chetter, and Daniel Carradice, from the Academic Vascular Surgical Unit at Hull York Medical School, aimed to assess the efficacy of both procedures and identify potential differences in outcomes.
The meta-analysis, encompassing four Randomized Controlled Trials (RCTs) and involving 654 patients, focused on primary outcomes, including anatomical occlusion rate, disease-specific quality of life, procedural and postprocedural pain, and rates of venous thromboembolism.
Key findings from the meta-analysis revealed that the anatomical occlusion rate after one year was significantly lower with MOCA compared to EVTA, with a risk ratio of 0.85 (95% confidence interval 0.78 to 0.91; P < 0.001). However, no significant differences were detected in procedural pain, postprocedural pain, Aberdeen Varicose Vein Questionnaire score at one year, or incidence of venous thromboembolism.
The researchers, including Arthur J M Lim and the entire team, concluded that while MOCA demonstrated a lower success rate in achieving anatomical occlusion compared to EVTA, there were no notable differences in procedural and postprocedural pain between the two interventions. The study emphasized the need for long-term data to evaluate the impact of reduced vein occlusion rates on clinical outcomes such as quality of life and the potential need for reintervention.
The Plain Language Summary of the research underscores that MOCA, although offering potential benefits such as reduced pain and fewer complications, did not prove to be as successful as EVTA in blocking diseased veins. At one year, both treatment groups reported similar levels of quality of life, but the inferior success rate of MOCA in blocking veins may impact the duration of improvement and warrant further investigation.
It’s important to note that there was no evidence supporting the replacement of EVTA with MOCA as the first-line treatment for the majority of patients. However, MOCA remains a viable treatment option for selected individuals.
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