3 The procedure
3.1 Endovenous mechanochemical ablation for varicose veins combines mechanical ablation with the use of sclerosing agents to close veins without the need for tumescent anaesthesia (infusion of a large volume of dilute local anaesthetic around and along the entire length of vein to be treated).
3.2 The procedure is carried out using local anaesthesia at the catheter insertion site. Ultrasound imaging is used to identify the target vein, its diameter and the length of the section of vein to be treated. An infusion catheter with a motor drive is introduced percutaneously into the distal end of the target vein and, in the case of the great saphenous vein, the catheter tip is advanced to the saphenofemoral junction. A dispersion wire that extends through the catheter lumen is rotated to damage the epithelium and a sclerosant is infused simultaneously as the catheter is slowly pulled back through the vein. Patients are advised to wear compression stockings for about 2 weeks after the procedure.