Comment to: Mechanochemical tumescentless endovenous ablation: final results of the initial clinical trial, by Elias S, Raines JK. Phlebology 2012;27:67-72.

A new mechanochemical device, (ClariVein_w, Madison, CT, USA), that does not require a generator or the use of tumescent anesthesia, was developed to achieve venous occlusion utilizing a wire rotating within the lumen of the vein at 3500 rpm that abrades the intima to allow for improve the efficacy of the sclerosant. A liquid sclerosant (sodium tetradecyl sulphate) is concomitantly infused through an opening close to the distal end of the catheter near the rotating wire. The wire tip is positioned 2 cm from the saphenofemoral junction under ultrasound guidance. With the wire rotating and during sclerosant infusion, the catheter is pulled down the vein at a rate of approximately 1–2 mm per second. Catheter wire rotation is first activated for 2–3 s at the highest speed setting to create venospasm which minimizes forward flow into the common femoral vein. This is a single-use device that can be inserted through a 4 or 5 French guiding catheter with local insertion site anesthesia only, without the need for tumescence anesthesia. The system includes an infusion catheter, motor drive, stopcock and syringe....