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논문 기본 정보

자료유형
학술저널
저자정보
전강웅 (가톨릭대학교 부천성모병원 혈관이식외과) 조성신 (강동경희대학교병원 혈관외과)
저널정보
대한의사협회 대한의사협회지 대한의사협회지 제65권 제4호
발행연도
2022.4
수록면
217 - 224 (8page)
DOI
http://dx.doi.org/10.5124/jkma.2022.65.4.217

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초록· 키워드

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Background: The mainstream of incompetent saphenous veins treatment has dramatically changed from the first-generation conventional high ligation and stripping surgery to the second-generation endovenous thermal ablation as a minimally invasive technique using laser or radiofrequency. The third-generation treatment of non thermal non-tumescent techniques is already available, including cyanoacrylate adhesive closure (CAC) and mechanochemical ablation (MOCA). Current Concepts: The non-thermal non-tumescent techniques are developed to overcome the complications of thermal ablation, including nerve injury and vein perforation. The technique also reduces the need for painful tumescent anesthesia and postoperative compression. MOCA employs a dual injury using a single-catheter-based delivery system consisting of a mechanical abrasion with a rotating wire and chemical ablation with a sclerosant. CAC is executed by injecting a glue that produces a polymer with the blood and obliterates the lumen. CAC does not need tumescent anesthesia and postoperative compression. Therefore, patient recovery is fast and satisfaction is excellent. However, the new devices are expensive and not included in the medical insurance in Korea, and long term effects of the new treatments are unproven; therefore, the cost-effectiveness is unconfirmed. Discussion and Conclusion: MOCA and CAC are newly developed minimal invasive treatments for varicose veins. They are reported to be safe and effective techniques. However, further studies are needed to evaluate the long-term outcomes and cost-effectiveness.

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