Comparison of microbubble presence in the right heart during mechanochemical and radiofrequency ablation for varicose veins

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Title: Comparison of microbubble presence in the right heart during mechanochemical and radiofrequency ablation for varicose veins
Authors: Moon, KH
Dharmarajah, B
Bootun, R
Lim, CS
Lane, TRA
Moore, HM
Sritharan, K
Davies, AH
Item Type: Journal Article
Abstract: Objective Mechanochemical ablation is a novel technique for ablation of varicose veins utilising a rotating catheter and liquid sclerosant. Mechanochemical ablation and radiofrequency ablation have no reported neurological side-effect but the rotating mechanism of mechanochemical ablation may produce microbubbles. Air emboli have been implicated as a cause of cerebrovascular events during ultrasound-guided foam sclerotherapy and microbubbles in the heart during ultrasound-guided foam sclerotherapy have been demonstrated. This study investigated the presence of microbubbles in the right heart during varicose vein ablation by mechanochemical abaltion and radiofrequency abaltion. Methods Patients undergoing great saphenous vein ablation by mechanochemical abaltion or radiofrequency ablation were recruited. During the ablative procedure, the presence of microbubbles was assessed using transthoracic echocardiogram. Offline blinded image quantification was performed using International Consensus Criteria grading guidelines. Results From 32 recruited patients, 28 data sets were analysed. Eleven underwent mechanochemical abaltion and 17 underwent radiofrequency abaltion. There were no neurological complications. In total, 39% (11/28) of patients had grade 1 or 2 microbubbles detected. Thirty-six percent (4/11) of mechanochemical abaltion patients and 29% (5/17) of radiofrequency ablation patients had microbubbles with no significant difference between the groups (p=0.8065). Conclusion A comparable prevalence of microbubbles between mechanochemical abaltion and radiofrequency ablation both of which are lower than that previously reported for ultrasound-guided foam sclerotherapy suggests that mechanochemical abaltion may not confer the same risk of neurological events as ultrasound-guided foam sclerotherapy for treatment of varicose veins.
Issue Date: 10-Aug-2016
Date of Acceptance: 1-Aug-2016
URI: http://hdl.handle.net/10044/1/50566
DOI: https://dx.doi.org/10.1177/0268355516661113
ISSN: 0268-3555
Publisher: SAGE Publications
Start Page: 425
End Page: 432
Journal / Book Title: Phlebology
Volume: 32
Issue: 6
Copyright Statement: © The Author(s) 2016. Published by Sage Publications. The final, definitive version of this paper has been published in Phlebology by Sage Publications Ltd. All rights reserved. It is available at: http://journals.sagepub.com/doi/full/10.1177/0268355516661113
Keywords: Science & Technology
Life Sciences & Biomedicine
Surgery
Peripheral Vascular Disease
Cardiovascular System & Cardiology
Microbubbles
radiofrequency
mechanochemical
ablation
varicose veins
PATENT FORAMEN OVALE
FOAM SCLEROTHERAPY
ENDOVENOUS ABLATION
CLINICAL-TRIAL
EMBOLISM
MANAGEMENT
DIAGNOSIS
STROKE
DEVICE
SAFETY
1102 Cardiovascular Medicine And Haematology
Cardiovascular System & Hematology
Publication Status: Published
Appears in Collections:Division of Surgery
Faculty of Medicine



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