Mechanochemical ablation (MOCA) for superficial venous insufficiency: a protocol for a systematic review with meta-analysis.

Varicose veins are a common disease worldwide, mainly affecting adults, and are estimated to be the 7th most common reason for physician referral in the USA. There is no ideal technique for treatment of varicose veins. Several techniques have emerged in recent years: the most widely used are thermal techniques such as laser and radio frequency and non-thermal techniques such as chemical and mechanochemical ablation (MOCA). MOCA employs a combination of physical damage to the vessel with infusion of a sclerosant fluid with the objective of improving the effects and avoiding disadvantages of thermal ablation such as pain and nerve injuries. The aim of this study will be to evaluate the effects of MOCA for treatment of superficial varicose veins in the lower limbs. We will search randomized controlled trials of MOCA for treatment of varicose veins. The search strategy will include free text terms and controlled vocabulary terms (e.g. Emtree, MeSH) for 'varicose veins', 'varices', 'ablation', 'mechanical ablation', 'chemical ablation', and 'mechanochemical ablation'. We will search at least the following databases: Medline (via Pubmed), Embase, Cochrane Central Register of Controlled Trials, Lilacs, Ibecs, WHO Clinical Trials Platform, and Clinicaltrials.com. The risks of bias will be evaluated with the Cochrane tool. We will report structured summaries of the included studies and conduct meta-analyses if possible. Development of new treatments such as MOCA must be encouraged and validation by systematic reviews is required to demonstrate their effects and support better clinical treatment decisions.