Comparison of Non-Tumescent n-Butyl Cyanoacrylate and Endovenous Laser Therapy in Saphenous Vein Ablation

Objective: Ablation of N-butyl cyanoacrylate (NBCA) and endovenous laser ablation (EVLA) are two important techniques used in the treatment of venous insufficiency. The aim of this study is to compare the results of EVLA and NBCA methods in the treatment of saphenous vein insufficiency. Method: 739 patients with saphenous vein insufficiency who were followed up between 2013 and 2018 and treated with NBCA (350 patients) and EVLA (389 patients) applications were included in the study. Pre-procedure, during, post-procedure and follow-up data of the patients were collected and compared retrospectively. Results: In the group using NBCA technique; mean age was 46.09±6.12 years, mean age was 48.08±6.11 years in the EVLA technique group. The mean ablated vein length was 32.97-65.83 cm in the NBCA group and 30.65-67.25 cm in the EVLA group. The mean procedure time was 7 minutes in the NBCA group and 18 minutes in the EVLA group. The 12-month total occlusion rates in the NBCA and EVLA groups were 98.8% and 97.6%, respectively. In both the NBCA and EVLA groups, the post-procedure Venous Clinical Severity Score (VCSS) was significantly reduced with no difference between the groups. When NBCA treatment was compared with EVLA treatment, it was seen that there may be fewer side effects after NBCA treatment. Conclusion: When the treatment success rates, application times, complication rates and venous clinical severity scoring results in the data obtained in our study were evaluated, it was thought that the NBCA method was as successful and reliable as the EVLA method. In conclusion; It has been suggested that the vascular closure system with NBCA is a fast and effective treatment method in the treatment of saphenous vein insufficiency, as it does not require tumescent anesthesia, does not require compression stockings, and does not have the risk of paresthesia, burn scars or pigmentation.

The Success Rate and Complications of Post-radiofrequency Ablation in Patients With Small Saphenous Insufficiency

Aims: This study aimed to determine the success rate and complications occurring after Radiofrequency Ablation (RFA) in patients with small saphenous insufficiency who underwent RFA in Rasht. Methods & Materials: Patients with small saphenous vein insufficiency who underwent RFA were explored respecting success rate and potential complications, such as pain, hematoma, neuropathy, Endothermal Heat-Induced Thrombosis (EHIT), and skin burns. The study subjects were assessed 2 weeks after the procedure. Reconanalysis was followed up in the study participants by ultrasound at 2 weeks, 3-6 months, and the first year after RFA. Findings: This study examined 62 patients. A 100% success rate was reported and no case of reflux was observed in the first control ultrasound 2 weeks after RFA. The mean pain score significantly decreased (P<0.001). Besides, in one year, 3 cases of recanalization, 7 cases of EHIT, 9 cases of neuropathy, and 1 case of superficial thrombophlebitis were reported; no case of skin burn was observed. Conclusion: Considering the 100% success rate and slight adverse effects of this method, such as pain and recanalization, RFA is an acceptable approach. Furthermore, the incidence of EHIT should be considered.

Early period results of radiofrequency ablation and cyanoacrylate embolization for great saphenous vein insufficiency

Objective To evaluate the 6 months efficacy and safety of cyanoacrylate closure for the treatment of incompetent great saphenous veins (GSVs) in comparison with radiofrequency ablation (RFA). Methods In this multicenter, retrospective, clinical trial, 398 symptomatic subjects with incompetent GSVs were assigned to either cyanoacrylate closure or RFA. The primary endpoint, complete closure of the target GSV, was determined using duplex ultrasound examination starting from one-, three-, and six-month visits. Results All patients were followed for 6 months and there was no difference between the groups in terms of mean follow-up time. Hospital stay and return to work/activity were shorter in the cyanoacrylate ablation (CAA) group, and these differences between the groups were statistically significant. Ecchymosis was observed higher in the RFA group and was statistically significant. Conclusions In this study, in which we examined the CAA and RFA methods, we found that both methods were effective and reliable; however, we found that patients in the CAA group had a more comfortable postoperative period and returned to work earlier.

VariClose® vein sealing system is inferior to endovenous laser ablation for the treatment of varicose veins

Background One of the three commercially available cyanoacrylate venous glues used for the treatment of saphenous vein insufficiency is the VariClose® vein sealing system. Previous studies have documented a high rate of occlusion and minimal postoperative complications. The aim of this study was to compare occlusion rates and clinical outcomes of endovenous laser treatment with the VariClose® vein sealing system in the treatment of truncal vein insufficiency. Patients and methods Retrospective non-randomized single center study with prospectively collected data comparing endovenous laser treatment and VariClose® procedures between April 2018 and November 2019. Results VariClose® was used in 27 patients (30 veins) and endovenous laser treatment in 42 patients (51 veins). The occlusion rate at one, three, and six months were 96%, 85%, and 65% for VariClose® procedures and 100%, 100%, and 97% for endovenous laser treatment procedures ( p = 0.01), respectively. Reduction of VCSS scores before treatment and at the last postoperative follow-up visit in the VariClose® group dropped by an average of 1.8 ± 1.6 and in the endovenous laser treatment by an average of 3.3 ± 2.9 ( p = 0.01). Conclusion VariClose® vein sealing system is inferior to endovenous laser treatment as a treatment option for varicose veins as it has a higher recanalization rate.