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Vasa. 2018 Aug;47(5):416-424. doi: 10.1024/0301-1526/a000716. Epub 2018 Jun 12.

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

Author information

1
1 Department of Cardiology, 2nd Faculty of Medicine, Charles University, Prague and Motol University Hospital, Prague, Czech Republic.
2
2 Department of Radiology, 2nd Faculty of Medicine, Charles University, Prague and Motol University Hospital, Prague, Czech Republic.
3
3 Cardiology Clinic of the 2nd Faculty of Medicine, Charles University, Prague and Motol University Hospital, Prague, Czech Republic.
4
4 Ambulant angiography, Prague, Czech Republic.
5
5 Angiology Zbraslav, Prague, Czech Republic.

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.

KEYWORDS:

Varicose veins; endovascular technique; histoacryl; lipiodol; saphenous veins; venous ulcer

PMID:
29890917
DOI:
10.1024/0301-1526/a000716
[Indexed for MEDLINE]
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