scholarly journals Cyanoacrylate Glue Closure for Varicose Veins: Concensus Guidlines of the Japanese Society of Phlebology

2020 ◽  
Vol 31 (3) ◽  
pp. 141-152
Author(s):  
Masayuki Hirokawa ◽  
Hirono Satokawa ◽  
Takumi Yasugi ◽  
Takashi Yamaki ◽  
Takaaki Ito ◽  
...  
Keyword(s):  
Japanese Society ◽  
Varicose Veins ◽  
Cyanoacrylate Glue

Cyanoacrylate adhesive embolization and sclerotherapy for primary varicose veins

2017 ◽  
Vol 33 (8) ◽  
pp. 547-557 ◽  
Author(s):  
Krishna Prasad Bellam Premnath ◽  
Binu Joy ◽  
Vijayakumar Akondi Raghavendra ◽  
Ajith Toms ◽  
Teena Sleeba
Keyword(s):  
Saphenous Vein ◽  
Great Saphenous Vein ◽  
Varicose Veins ◽  
Clinical Severity ◽  
Cyanoacrylate Glue ◽  
Cyanoacrylate Adhesive ◽  
Venous Clinical Severity Score ◽  
Primary Varicose Veins ◽  
Vein Reflux

Various treatment methods are available for the treatment of varicose veins, and there has been a recent surge in the usage of cyanoacrylate glue for treating varicose veins. Purpose To investigate the technical possibility, efficiency and safety of cyanoacrylate adhesive embolization and sclerotherapy using commonly available n-butyl cyanoacrylate glue for the treatment of primary varicose veins due to great saphenous vein reflux with or without incompetent perforators. Materials and Methods One hundred forty-five limbs of 124 patients with varicose veins due to great saphenous vein reflux were subjected to cyanoacrylate adhesive embolization and sclerotherapy – adhesive embolization of great saphenous vein in the thigh and perforators using cyanoacrylate followed by sclerotherapy of any residual varicose veins in the leg. Procedural success, venous closure rates and clinical improvement were assessed. Follow-up for 1, 3, 6, 9 and 12 months was obtained. Results Technical success rate was 100%. Saphenous vein closure rate was 96.5% at one year. There was no femoral venous extension of cyanoacrylate in any of the patients. Posterior tibial vein extension of cyanoacrylate was seen in three patients (2.6%) without untoward clinical effect.Significant improvement was found in venous clinical severity score (VCSS) from a baseline mean of 7.98 ± 4.42 to 4.74 ± 3, 1.36 ± 1.65 and 0.79 ± 1.19 at 1, 6 and 12 months’ follow-up. Ulcer healing rate was 100%. Conclusion Cyanoacrylate adhesive embolization and sclerotherapy for the treatment of primary varicose veins is efficacious and can be performed as an outpatient procedure, but has a guarded safety profile due to its propensity to cause deep venous occlusion if not handled carefully.

Endovenous cyanoacrylate glue to treat varicose veins and chronic venous insufficiency—Experience gained from our first 100+ truncal venous ablations in a multi-ethnic Asian population using the Medtronic VenaSeal™ Closure System

2019 ◽  
Vol 34 (8) ◽  
pp. 543-551 ◽  
Author(s):  
Tjun Y Tang ◽  
Harsha P Rathnaweera ◽  
Jia W Kam ◽  
Tze T Chong ◽  
Edward C Choke ◽  
...  
Keyword(s):  
Saphenous Vein ◽  
Chronic Venous Insufficiency ◽  
Venous Insufficiency ◽  
Great Saphenous Vein ◽  
Varicose Veins ◽  
Asian Population ◽  
Closure System ◽  
Cyanoacrylate Glue ◽  
Catheter Technique

Objectives The aim of this prospective single-centre study is to assess the effectiveness and patient experience of the VenaSeal™ Closure System, a novel non-thermal, non-tumescent catheter technique, which uses cyanoacrylate glue to occlude the refluxing truncal superficial veins to treat varicose veins and chronic venous insufficiency, in a multi-ethnic Asian population from Singapore. Methods Seventy-seven patients (93 legs; 103 procedures) underwent VenaSeal™ Closure System ablation. Forty-nine (63.6%) for great saphenous vein incompetence, 16 (20.8%) bilateral great saphenous vein, 2 (2.6%) small saphenous vein and 10 (13.0%) combined unilateral great saphenous vein and small saphenous vein/anterior thigh vein reflux. In addition, 65/93 legs (69.9%) had C4–C6 disease. Patients were reviewed at 2 weeks, 3, 6 and 12 months post-procedure. Results There was 100% technical success. 28/77 (36.4%) underwent concomitant phlebectomies. All procedures were well tolerated with a mean post-operative pain score of 3.0 (range: 0–5). After three months, median patient satisfaction was 9.0 (interquartile range: 7.0–10.0). At two-week follow-up, the great saphenous vein was completely occluded in 88/88 (100%) veins and small saphenous vein completely closed in 11/11 (100%) veins. At three-month follow-up, the great saphenous vein was occluded in 51/53 (96.2%) veins and small saphenous vein completely closed in 5/5 (100%) veins. At six-month follow-up, the great saphenous vein was completely occluded in 42/45 (93.3%) veins and small saphenous vein completely closed in 5/7 (71.4%) veins. At one year, great saphenous vein and small saphenous vein occlusion rates were 54/59 (91.5%) and 5/8 (62.5%), respectively. There was one deep vein thrombosis. Transient superficial phlebitis was reported in 10/93 (10.8%) legs, which were all self-limiting. There were 9/103 (8.7%) anatomical recurrences, but no patients required re-intervention as they were asymptomatic. Conclusions Cyanoacrylate glue is a safe and efficacious modality to ablate refluxing saphenous veins in Asian patients in the short term. There is a high satisfaction rate and peri-procedural pain is low. Early results are promising but further evaluation and longer term follow-up are required.

What is effective care for varicose veins?

2016 ◽  
Vol 31 (1_suppl) ◽  
pp. 80-87 ◽  
Author(s):  
Mark H Meissner
Keyword(s):  
Quality Of Life ◽  
Effective Treatment ◽  
Varicose Veins ◽  
Treatment Options ◽  
Cost Effective ◽  
Symptom Improvement ◽  
Ultrasound Guided ◽  
Foam Sclerotherapy ◽  
Cyanoacrylate Glue

Varicose veins affect one-quarter to one-third of Western adult populations and consume an increasing amount of health care resources. Much of this increased utilization has been driven by the advent of minimally invasive technology including endovenous thermal ablation, foam sclerotherapy, and more recently mechanicochemical and cyanoacrylate glue ablation. This has largely been driven by patient and physician preferences in the absence of robust evidence that one therapy is truly superior to another. This partially arises from misunderstandings about appropriate outcomes measures and what truly constitutes effective treatment of varicose veins. Technical outcomes, such as saphenous closure rates, have frequently been used as surrogates for effective treatment but are poorly correlated with symptom improvement, quality of life, and risk of recurrence. Although there does appear to be a trend towards higher recurrence with ultrasound-guided foam sclerotherapy, the data are occasionally conflicting and there does not appear to be substantial differences between the various modalities. Similarly, there do not appear to be major differences in late quality of life measures between these treatment options. As long-term differences in recurrence and quality of life are small, overall cost effectiveness is driven primarily by initial treatment costs and ultrasound-guided foam sclerotherapy is the most cost-effective strategy in many models. However, there continues to be substantial uncertainty surrounding cost estimates and other factors of importance to the patient may ultimately drive treatment decisions. The benefits of some adjuncts to the treatment of axial superficial reflux, such as the concurrent versus staged management of tributary varicosities, remain ill-defined while that of others, such as routine post-procedural ultrasound surveillance and compression, need critical re-evaluation.

Treating great and small saphenous vein insufficiency with histoacryl in patients with symptomatic varicose veins and increased risk of surgery

VASA ◽  
2018 ◽  
Vol 47 (5) ◽  
pp. 416-424 ◽  
Author(s):  
Karel Novotný ◽  
Míla Roček ◽  
Radek Pádr ◽  
Radim Pavlík ◽  
Michal Polovinčák ◽  
...  
Keyword(s):  
Saphenous Vein ◽  
Venous Insufficiency ◽  
Varicose Veins ◽  
Clinical Severity ◽  
Cyanoacrylate Glue ◽  
Venous Ulceration ◽  
Increased Risk ◽  
Venous Clinical Severity Score ◽  
Vein Insufficiency

Abstract. Background: Treating great and small saphenous vein trunk insufficiency with cyanoacrylate glue is the least taxing treatment method of all available techniques. Due to long-term unavailability of commercial kits with n-butyl-2-cyanoacrylate (histoacryl) in the Czech Republic, we used a modified technique. Patients and methods: Fifty-six limbs in 49 patients suffering from great saphenous vein or small saphenous vein insufficiency in combination with symptomatic chronic venous insufficiency and complicating comorbidities were treated with a modified endovascular cyanoacrylate glue application technique. Results: The immediate success rate of the treatment was 98 %. In follow-up intervals of six weeks, six months, one year, and two years, the anatomical success rates of embolization (recanalization of no more than 5 cm of the junction) were 98, 96, 94, and 94 %, respectively. At identical intervals the venous insufficiency was scored according to the Aberdeen Varicose Vein Questionnaire and the American Venous Clinical Severity Score. In both cases, improvement was demonstrated over the two-year follow-up, with a 0.5 % significance level. Specific clinical signs of venous insufficiency were also evaluated, such as pain, oedema, clearance of varicose veins, and healing of venous ulceration. One severe complication – a pulmonary embolism – was reported, without consequences. Conclusions: We demonstrated that treating insufficient saphenous veins with modified histoacryl application brought a relief from symptoms of venous insufficiency and that the efficiency of this technique is comparable to commonly used methods.

scholarly journals Cyanoacrylate glue embolisation for varicose veins – A novel complication

2020 ◽  
Vol 35 (7) ◽  
pp. 520-523 ◽  
Author(s):  
Benjamin J Langridge ◽  
Sarah Onida ◽  
Justin Weir ◽  
Hayley Moore ◽  
Tristan RA Lane ◽  
...  
Keyword(s):  
Patient Outcome ◽  
Foreign Body ◽  
Foreign Body Reaction ◽  
Surgical Intervention ◽  
Varicose Veins ◽  
Tolerability Profile ◽  
Cyanoacrylate Glue ◽  
Vein Thrombosis ◽  
Deep Vein ◽  
Endovenous Treatment

Background Non-thermal non-tumescent methods for varicose vein treatment have rapidly gained popularity in recent years due to clinical efficacy comparable to other endovenous methods, but with a superior safety and tolerability profile. Cyanoacrylate is an adhesive that rapidly polymerises during endovenous treatment to cause rapid occlusion of veins and initiate vein fibrosis. Method Cyanoacrylate glue treatment is known to cause complications such as phlebitis, cellulitis and deep vein thrombosis in rare instances. We present the first reported case of cyanoacrylate extravasation with chronic foreign body reaction in a patient nine months after initial treatment. Results We discuss the aetiology of this complication, its treatment, patient outcome and its significance to both clinicians and patients. Conclusion Cyanoacrylate glue embolisation can, in rare instances, lead to extravasation and chronic foreign body reaction, necessitating surgical intervention. The relative novelty of cyanoacrylate glue embolisation in the treatment of varicose veins requires clinicians to monitor for rare complications during its use in clinical practice. Patients should be aware of the rare risk of glue extravasation and foreign body reaction for fully informed consent prior to treatment.

scholarly journals Audit of the efficacy and complications of cyanoacrylate glue embolisation to treat varicose veins in primary care

2019 ◽  
Vol 11 (3) ◽  
pp. 249 ◽  
Author(s):  
Isaac Weaver ◽  
Paul Weaver
Keyword(s):  
Primary Care ◽  
Saphenous Vein ◽  
Great Saphenous Vein ◽  
Varicose Veins ◽  
Clinical Severity ◽  
Foam Sclerotherapy ◽  
Cyanoacrylate Glue ◽  
Clinical Records ◽  
Glue Embolization ◽  
Medical Adhesive

ABSTRACT INTRODUCTIONCyanoacrylate glue embolization (CAGE) is a non-surgical procedure that uses a proprietary medical adhesive, delivered endovenously to close truncal, varicose veins. AIMTo describe CAGE administered by a New Zealand general practitioner (GP) in primary care. METHODSThe procedures were performed by a single GP with a special interest and 19 years’ clinical experience in procedural phlebology. The clinical records of 107 consecutive patients who underwent CAGE over a 2-year period were retrospectively reviewed. Some patients had bilateral disease and some had more than one truncal vein per leg treated. Data on 173 truncal veins were included in the audit. Clinical data, procedural details and postprocedural course were recorded and analysed for 71 females and 36 males. RESULTSIn total, 173 truncal veins were treated. They included the anterior accessory saphenous vein, the great saphenous vein, the small (lesser) saphenous vein and the thigh extension with a range of clinical severity. The most commonly treated truncal vein was the great saphenous vein with an average truncal diameter of 8.8mm (2.9s.d.). Of the 173 treated truncal veins, two failed to seal with CAGE, but were sealed after adjuvant ultrasound-guided foam sclerotherapy treatment. Post CAGE, 14.5% of treated truncal veins developed a phlebitis. DISCUSSIONThis audit shows that varicose veins can be treated in general practice with high levels of anatomic efficacy and few adverse effects.

scholarly journals 8 years vein glue therapy with VenaSeal® – 8 special cases

2020 ◽  
Vol 5 (11) ◽  
Keyword(s):  
Health Authority ◽  
Chemical Compound ◽  
Varicose Veins ◽  
Tissue Adhesive ◽  
Closure System ◽  
Cyanoacrylate Glue ◽  
Saphenous Veins ◽  
Special Cases ◽  
The Usa ◽  
Operative Medicine

Since 1949 the chemical compound of cyanoacrylate glue is known, first being used in operative medicine in the early 60s. Tissue adhesive or replacement of wound sutures Nearly all operative disciplines were / are using cyanoacrylate i.e. dermatology, ophthalmology, orthopedics, surgery, orthodontics, interventional radiologists. The VenaSeal® - Closure System has been CE and ISO certified since 2011. The American health authority FDA announced the approval of the system in the USA in 2/2015. Until October 20th of 2020, vein glue is used successfully for the treatment of truncal varicose veins in over 160 000 cases worldwide. The authors have been working with the VenaSeal®-Closure System since August 1th. 2012, and have so far successfully treated 2840 saphenous veins in 1476 patients with the vein glue. Closure effectiveness of 96,09% achieved over 98 months.

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