Utility of Ultrasound in the Treatment of Varicose Veins Using ClariVein

Purpose: This study evaluated the clinical utility of duplex ultrasound in guiding mechanochemical ablation (MOCA) using the ClariVein® device for the treatment of great saphenous vein (GSV) insufficiency.Methods : : Forty-four limbs with symptomatic varicose veins (CEAP C2 or higher) underwent ultrasound-guided MOCA. Sodium tetradecyl sulfate (STS, 1.5%) was used as the sclerosant. Duplex ultrasound was used preoperatively to assess the reflux and vein diameter, intraoperatively to guide catheter placement and sclerosant distribution, and postoperatively to evaluate the occlusion, recanalization, and complications. Follow-up duplex ultrasound imaging was performed at one week, one month, and six months. The clinical outcomes were assessed using the Venous Clinical Severity Score (VCSS) and the Aberdeen Varicose Vein Questionnaire (AVVQ). Statistical analysis was conducted using the Wilcoxon signed-rank test.Results : : The mean VCSS decreased from 4.8 ± 1.53 to 1.66 ± 0.78 (P < 0.001), and the AVVQ improved from 11.05 ± 3.52 to 4.45 ± 1.86 (P < 0.001). Ultrasound guidance enabled accurate catheter positioning and uniform sclerosant delivery, minimizing treatment failure. Minor complications included superficial phlebitis (9.1%) and transient sensory changes (4.5%), while no major complications were reported. Recanalization was detected in two cases (4.5%) on the follow-up ultrasound examination.Conclusion : : Ultrasound guidance enhances the safety and efficacy of MOCA by improving the diagnostic precision, real-time catheter navigation, and postoperative surveillance. Significant reductions in VCSS and AVVQ show its value in symptom relief and quality- of-life improvement. Duplex ultrasound should be considered a standard adjunct in the treatment of varicose veins with MOCA.