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Thursday 9 September 2010

Clarivein for varicose veins

This week there was an article in the Daily Mail about a new catheter based sclerotherapy technique for varicose vein treatments called "Clarivein".

We have had many people contacting us at The Whiteley Clinic asking if we recommend this technique, how it works and if we provide Clarivein for the treatment of varicose veins.

From the information available from the company, a study in the USA has shown that treated veins are "occluded" in 29 of 30 people treated in the short term. However there is no information as to whether this "occlusion" is just due to the veins having blood clots in it, or if it has been successfully closed by destroying the wall.

Research and experience on sclerotherapy in big veins shows that big veins treated with sclerotherapy often appear "occluded" in the short term, but the clots dissolve over several months meaning that the veins open up again and the varicose veins return.

The Clarivein technique is sclerotherapy but it also adds a catheter that rotates, spreading the sclerotherapy inside the vein and maybe damaging the wall. This might improve the expected results from this technique - however there is no evidence available at the moment that the vein wall is damaged enough to cause a permanent closure of the vein.

EVLA (Laser) and Radiofrequency Ablation (RFiTT and VNUS) - when used correctly under local anaesthetic - have all been shown to close the vein wall permanently without causing clot in the vein - giving excellent long term results. Hence we offer all f these techniques to suitable patients.

As a specialist clinic we are committed to only offering our patients treatments that our experts are convinced give the best possible results - either by studying our own research or studying the research performed by others.

At the time of writing this, and on the information provided to date, we are not happy to offer Clarivein to our patients unless as part of a study. We have asked the distributor of Clarivein in the UK to provide answers to questions which would allow us to be able to assess whether this technique is likely to have good long-term outcomes. Unfortunately, although we have had replies, we have not had answers to the questions that we have posed.

Therefore at the moment, although Clarivein is clearly a novel idea, our experts have some concerns as to the long-term efficacy of sclerotherapy treatments in large veins and therefore we need have several scientific questions answered before we will be happy to offer its to our patients.

If we would receive any further information to answer questions, or if we start any research of our own into this product, this will be announced on our website and on this blog.

3 comments:

  1. Thanks for discussing all about Clarivein here. It is nice to know various information regarding the treatment option available for curing varicose veins. Nice sharing and keep posting.

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  2. Hi Mark - any update on your above blog would be great? What are your latest thoughts? I've been recommended the clarivein procedure by another surgeon but am concerned about what i am reading on the internet. Lauren.

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  3. Hi Lauren,

    Thank you for your question.

    I'm afraid that I haven't been given any more information from the company itself.

    Although we do have Clarivein available for our patients, we so far haven't found anyone who it is the best option for.

    The biggest problem at the moment is that when we examine our patients with our high resolution duplex ultrasound, we almost always find that they have more than one vein that is a problem or that they have perforators that need closing.
    Clarivein can only be used in one major vein at one session (due to maximum doses of sclerosant used) and can't be used for perforators.
    When we use RFiTT or EVLA, we can close up to 5 major veins at one go and using RFiTT or side firing laser, we can close truncal veins AND perforators at the same session.

    There to keep prices down for our patients and sessions to a minimum, we rarely find anyone suitable for Clarivein.

    Finally, until I have further information regarding whether the vein actually fibroses away completely, it still isn't recommended as part of The Whiteley Protocol.

    I hope this helps,

    Mark

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