An exciting new keyhole treatment for varicose veins, that avoids the need for multiple local anaesthetic injections during the treatment and reduces the need for bandaging afterwards is beginning to be introduced at the Cornwall Vein Clinic, although there is not enough evidence available yet, to say if this treatment is as good as endothermal ablation (RFA and EVLT).
In one technique, endovenous mechanochemical ablation (Clarivein™) a tube with a rotating hollow wire at its tip is inserted through the skin into the affected vein in the leg using ultrasound guidance, made under local anaesthetic. As the tube is pulled back out of the vein, the wire is rotated, damaging the lining of the vein. At the same time a chemical is injected through the hollow wire into the vein. The vein becomes inflamed, and then shrivels and closes.
This new treatment has the same potential complications as the established keyhole treatments (bruising, skin discolouration, nerve injury, deep vein thrombosis, allergic reaction, and failure to close the treated vein), but there is not yet enough information available about Clarivein™ to say if these complications are any more likely, or if the success rate of this treatment is any lower.