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Background <p>Varicose veins of the lower limbs, particularly involving the great saphenous vein (GSV), are a common vascular condition often requiring intervention. Conventional surgeries entail higher morbidity and prolonged recovery. To minimize complications while ensuring efficacy, a novel hybrid technique —Endovenous Chemical Ablation and Trendelenburg’s operation (eCAT) —was developed. This study aimed to evaluate the efficacy and safety of the eCAT operation for treating GSV varicosities.</p> Methods <p>A single-arm open-label interventional study was conducted on 500 patients with primary lower limb varicose veins (2014–2021). The eCAT procedure, developed by Walied Khereba at Al-Azhar University (New Damietta), combined Trendelenburg’s operation with polidocanol foam sclerotherapy under local anaesthesia. The primary outcome was GSV ablation efficacy at 1 week, 3 months, and 1 year. Secondary outcomes included postoperative complications, pain reduction, and factors influencing success.</p> Results <p>GSV ablation succeeded in all cases (100%). At 1 week, 88% of veins were fully occluded and 12% partially; at 3 months, full occlusion decreased to 76%, then improved to 88% at 1 year. Postoperative complications included oedema (30%), hyperpigmentation (20%), and residual varicosities (40%), all resolved by 1 year. Median pain scores decreased from 4 (IQR: 1) preoperatively to 2 (IQR: 1) at 1 week and 1 (IQR: 0) at both 3 months and 1 year (<i>P</i> = 0.001). Age, gender, and standing occupation significantly impacted early surgical success.</p> Conclusion <p>The eCAT is a safe, effective, and minimally invasive procedure for GSV varicosities treatment, achieving durable clinical outcomes with minimal complications and significant pain reduction.</p>

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Endovenous chemical ablation and trendelenburg’s (eCAT) operation for treating great saphenous vein varicosities: a single-arm open-label interventional study

  • 期刊论文

  • 出版模式：

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  • 发表日期：

    2026年2月4日

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  • Walied Khereba,
  • Al Metwaly Ragab,
  • Ayman Amen MohyElden,
  • Khaled Attia,
  • Osama Moeen,
  • Mohamed Ahmed Agena,
  • Elsayed Hadhoud,
  • Amr Bakr Mahmoud Elashry,
  • Ahmed Atef,
  • Maisa A. Abdel Wahab,
  • Nehal Farouk,
  • Sameh E. Elimam,
  • Ahmed Khairy Sakr,
  • Waleed E. Elshinawy,
  • Shimaa M. Elhalafawy,
  • Ahmed Ibrahim Badran,
  • Ahmed MT Radwan,
  • Mohamed Emad Eldin,
  • Mohamed Yahia Zakaria,
  • Reda Othman Abbas,
  • Hussien Montaser,
  • Elsayed Mohamed Abd El-Hamid,
  • Rasha S. Farag

摘要

Background

Varicose veins of the lower limbs, particularly involving the great saphenous vein (GSV), are a common vascular condition often requiring intervention. Conventional surgeries entail higher morbidity and prolonged recovery. To minimize complications while ensuring efficacy, a novel hybrid technique —Endovenous Chemical Ablation and Trendelenburg’s operation (eCAT) —was developed. This study aimed to evaluate the efficacy and safety of the eCAT operation for treating GSV varicosities.

Methods

A single-arm open-label interventional study was conducted on 500 patients with primary lower limb varicose veins (2014–2021). The eCAT procedure, developed by Walied Khereba at Al-Azhar University (New Damietta), combined Trendelenburg’s operation with polidocanol foam sclerotherapy under local anaesthesia. The primary outcome was GSV ablation efficacy at 1 week, 3 months, and 1 year. Secondary outcomes included postoperative complications, pain reduction, and factors influencing success.

Results

GSV ablation succeeded in all cases (100%). At 1 week, 88% of veins were fully occluded and 12% partially; at 3 months, full occlusion decreased to 76%, then improved to 88% at 1 year. Postoperative complications included oedema (30%), hyperpigmentation (20%), and residual varicosities (40%), all resolved by 1 year. Median pain scores decreased from 4 (IQR: 1) preoperatively to 2 (IQR: 1) at 1 week and 1 (IQR: 0) at both 3 months and 1 year (P = 0.001). Age, gender, and standing occupation significantly impacted early surgical success.

Conclusion

The eCAT is a safe, effective, and minimally invasive procedure for GSV varicosities treatment, achieving durable clinical outcomes with minimal complications and significant pain reduction.