Why Some Varicose Vein Treatments Look Good at First... But Disappoint Later (The Problem with MOCA)
- Jeffrey H. Miller, M.D.
- May 20
- 3 min read
If you’ve ever dealt with varicose veins, you know they are more than just a cosmetic issue. They can cause pain, swelling, and even skin damage.
Over the years, medical technology has advanced to offer several ways to treat these bulging veins without surgery. One such treatment is mechanochemical ablation, or MOCA.
It’s been marketed as a less invasive, less painful alternative. But a new expert review says the long-term results aren’t living up to the early hype.
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What is MOCA?
MOCA is a procedure that closes off faulty veins using a spinning wire inside the vein along with a chemical (called a sclerosing agent). It’s supposed to seal the vein shut without using heat, which is what other procedures like laser or radiofrequency ablation use.
Because it avoids heat, MOCA doesn’t need as much numbing medication and can be more comfortable during the procedure. Sounds great, right?
What the New Report Found
A recent commentary in the medical journal Phlebology casts doubt on how effective MOCA really is in the long run. Reviewing new 5-year data from a study of people who had their great saphenous vein (a major leg vein) treated with MOCA revealed mixed reviews.
The Good News
Right after the procedure, most patients had less leg pain, swelling, and visible veins
Their quality of life improved noticeably
The Not-So-Good News
Over time, many of these veins reopened (a problem called recanalization)
The longer it had been since the treatment, the more symptoms came back—like pain and swelling
By year five, some people needed repeat treatments—more often than patients who had other procedures like laser treatment
Why Does This Matter?
This matters because a treatment that looks successful at first isn’t much help if symptoms return down the road.
MOCA had a high technical success rate early on, but only about 81% of veins stayed closed after five years—and in some studies, the success rate was as low as 47%. That’s a big drop-off compared to other options like thermal treatment, which kept veins closed more than 90% of the time.
At Miller Vein, we pride ourselves on staying at the cutting edge of vein care, but we also believe strongly in evidence-based medicine.
Our decisions are always guided by high-quality scientific data and what’s best for our patients. Based on the accumulating evidence over time, Miller Vein made the decision to stop using MOCA treatments years ago.
The Bottom Line
MOCA is one of several ways to treat varicose veins, but it may not be the most durable option.
If you're considering treatment, ask your doctor not just about how you’ll feel right after the procedure—but also how likely the results are to last.
Understanding both the short-term benefits and long-term risks will help you make the best choice for your veins (and your peace of mind).
Source
Blebea, J. (2024). Invited Commentary: Mechanochemical ablation—disappointing long-term anatomic results and worsening symptoms. Phlebology, 39(4), 227–228. https://doi.org/10.1177/02683555231225612
Take the Next Step Toward Healthier Legs and a Better Life
If you have restlessness, heaviness, aching, swelling, throbbing, or itchiness in your legs—or you notice varicose veins or spider veins—it's time to see a vein specialist.
If you have any questions about this article, please put them in the comments below. We'll get back as soon as we can.
Thanks for reading!
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