Document Type : Original Article(s)
1 Associate Professor, Department of Cardiovascular Surgery, Corlu Province Hospital, Tekirdag, Turkey
2 Department of Cardiovascular Surgery, Umraniye Education and Research Hospital, Istanbul, Turkey
3 Department of Cardiovascular Surgery, Kirikkale Yuksek Ihtisas Hospital, Kirikkale, Turkey
4 Department of Cardiovascular Surgery, Derince Education and Research Hospital, Kocaeli, Turkey
5 Department of Radiology, School of Medicine, Kocaeli University, Kocaeli, Turkey
BACKGROUND: Cyanoacrylate (CA) has been used as an embolizing agent in the treatment of greater saphenous vein (GSV) insufficiency in recent years and the results regarding the use of this method have started to be published. To the best of our knowledge, the publications in literature do not mention about a significant negative effect of endovenous CA (EVCA) embolization. We aimed to evaluate the effects and undesirable events of this relatively new treatment method and compare them with literature, using the follow-up data of our patients.
METHODS: Patients who had GSV insufficiency for at least 3 months and were treated with EVCA embolization because of this disease were included in the study. Patients were excluded if they had deep vein thrombosis (DVT), excessive tortuous GSV, and peripheral neuropathy. Hospital archive records were reviewed and undesirable events like DVT, thrombophlebitis, and pain related to this treatment procedure were recorded.
RESULTS: EVCA embolization procedure was performed in a total of 54 patients with an average age of 49.36 ± 13.06 years for the purpose of treating GSV insufficiency. One patient was observed to develop n-butyl CA (NBCA) extension of approximately 5 mm from saphenofemoral junction (SFJ) to the main femoral vein and painful thrombophlebitic reaction was observed in 6 extremities at the first control examination.
CONCLUSION: In our opinion, while EVCA embolization is a treatment option with similar success rates to endovenous thermal ablation (EVTA), it should be kept in mind that there may be a possibility of developing thrombophlebitis and NBCA extension or thrombus extension to the deep veins.
- Proebstle TM, Alm J, Dimitri S, Rasmussen L, Whiteley M, Lawson J, et al. The European multicenter cohort study on cyanoacrylate embolization of refluxing great saphenous veins. J Vasc Surg Venous Lymphat Disord 2015; 3(1): 2-7.
- Almeida JI, Javier JJ, Mackay EG, Bautista C, Cher DJ, Proebstle TM. Two-year follow-up of first human use of cyanoacrylate adhesive for treatment of saphenous vein incompetence. Phlebology 2015; 30(6): 397-404.
- Koramaz I, El KH, Gokalp F, Bitargil M, Bektas N, Engin E, et al. Ablation of the great saphenous vein with nontumescent n-butyl cyanoacrylate versus endovenous laser therapy. J Vasc Surg Venous Lymphat Disord 2017; 5(2): 210-5.
- Puggioni A, Kalra M, Carmo M, Mozes G, Gloviczki P. Endovenous laser therapy and radiofrequency ablation of the great saphenous vein: Analysis of early efficacy and complications. J Vasc Surg 2005; 42(3): 488-93.
- Rasmussen LH, Lawaetz M, Bjoern L, Vennits B, Blemings A, Eklof B. Randomized clinical trial comparing endovenous laser ablation, radiofrequency ablation, foam sclerotherapy and surgical stripping for great saphenous varicose veins. Br J Surg 2011; 98(8): 1079-87.
- Almeida JI, Javier JJ, Mackay E, Bautista C, Proebstle TM. First human use of cyanoacrylate adhesive for treatment of saphenous vein incompetence. J Vasc Surg Venous Lymphat Disord 2013; 1(2): 174-80.
- Radak D, Djukic N, Neskovic M. Cyanoacrylate embolization: A novelty in the field of varicose veins surgery. Ann Vasc Surg 2019; 55: 285-91.
- Morrison N, Gibson K, McEnroe S, Goldman M, King T, Weiss R, et al. Randomized trial comparing cyanoacrylate embolization and radiofrequency ablation for incompetent great saphenous veins (VeClose). J Vasc Surg 2015; 61(4): 985-94.
- Yavuz T, Acar AN, Aydin H, Ekingen E. A retrospective study of a new n-butyl-2-cyanoacrylate glue ablation catheter incorporated with application guiding light for the treatment of venous insufficiency: Twelve-month results. Vascular 2018; 26(5): 547-55.
- Yasim A, Eroglu E, Bozoglan O, Mese B, Acipayam M, Kara H. A new non-tumescent endovenous ablation method for varicose vein treatment: Early results of N-butyl cyanoacrylate (VariClose(R)). Phlebology 2017; 32(3): 194-9.
- Tok M, Tuydes O, Yuksel A, Senol S, Akarsu S. Early-term outcomes for treatment of saphenous vein insufficiency with N-butyl cyanoacrylate: A novel, non-thermal, and non-tumescent percutaneous embolization technique. Heart Surg Forum 2016; 19(3): E118-E122.
- Calik ES, Arslan U, Ayaz F, Tort M, Yildiz Z, Aksu V, et al. N-butyl cyanoacrylate in the treatment of venous insufficiency--the effect of embolisation with ablative polymerisation. Vasa 2016; 45(3): 241-6.
Bozkurt AK, Yilmaz MF. A prospective comparison of a new cyanoacrylate glue and laser ablation for the treatment of venous insufficiency. Phlebology 2016; 31(1 Suppl): 106-13.