Mid-Term Results of Cyanoacrylate Embolization of Saphenous Veins

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OBJECTIVE

To evaluate the results of cyanoacrylate embolization (CAE) of great (GSV) and small (SSV) saphenous veins in patients with varicose veins (VVs) of the lower limbs.

MATERIAL AND METHODS

This is an ongoing prospective observational study including patients with VVs who underwent CAE of GSV or SSV. The outcomes are assessed in a week, 1, 3, 6 and 12 months after surgery, and then every year. Efficacy criteria are technical success, no vein recanalization, absence of residual reflux along the vein and within sapheno-femoral junction, GSV stump length, vein involution, no need for additional treatment for varicose tributaries after 3 months, no need for redo intervention on the treated vein, absence of varicose vein recurrence, reduction of CEAP class and VCSS score. Safety criterion is the absence of adverse reactions (ARs) associated with CAE.

RESULTS

CAE was performed on 142 limbs in 115 patients with VVs. GSV trunk was embolized in 82% of cases, SSV trunk — in 18%. Technical success was achieved in all cases. GSV stump length varied from 0 to 45 mm (mean 16.7±9.0 mm). Sclerotherapy for varicose tributaries within 3 months was performed on 80 (56%) legs. Follow-up period was 1-24 months. Additional sclerotherapy of tributaries was required for 38 (27%) limbs. GSV involution was observed in 3 (2%) cases within 12-24 months. Trunk recanalization within 3-12 months after intervention was found on 13 out of 142 (9%) limbs with reflux at the junction and on 3 out of 117 (2%) limbs after GSV obliteration. VV recurrence occurred on 8 (6%) limbs, as reported by the investigator, and on 3 (2%) limbs, as reported by the patient. AEs included phlebitis of the trunk (n=16; 11%) and thrombophlebitis of residual tributaries (n=8; 6%), cord sensation (n=8; 6%), glue propagation out of the junction (n=3; 2%), skin sensitivity disturbance (n=5; 4%), subcutaneous granuloma (n=1; 1%), subcutaneous hematoma (n=2; 1%), deep vein thrombosis (n=1; 1%), and allergy (5 out of 115 patients; 4%).

CONCLUSION

CAE is a reliable method for saphenous vein ablation.

Keywords:

chronic venous disease

varicose veins

cyanoacrylate embolization

endovenous obliteration

Authors:

E.L. Murzina

Neftyanik Hospital

K.V. Lobastov

Pirogov Russian National Research Medical University

ORCID: 0000-0002-5358-7218

A.B. Bargandzhiya

Pirogov Russian National Research Medical University

L.A. Laberko

Pirogov Russian National Research Medical University

I.B. Popov

Tyumen State Medical University

Received:

24.05.2020

Accepted:

24.06.2020

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