Authors
Shirinbek О.1, Blinov D.V.1, 2, Mnatsakanyan G.V.1, Odinokova S.N.3
1 «SM-Clinic» Multiprofile Medical Holding, Moscow
2 Phlebology Center «Venosan», Zheleznodorozhniy
3 I.M. Sechenov First Moscow State Medical University, Moscow
Abstract
Objective. To evaluate the immediate and medium-term results of cyanoacrylate adhesive closure (CАС) in the treatment of patients with varicose veins at one medical center setting.
Material and methods. The study was performed at the “Venosan” Phlebological Center (Zheleznodorozhny city, Moscow region). The inclusion criteria were: CEAP classes C2-C6, junctional incompetence and axial reflux lasting more than 0.5 sec, the diameter of the trunk of the saphenous vein ≥ 5 mm and the presence of varicose tributaries. All patients underwent VenaSeal procedure. In all cases, an isolated truncal ablation was performed without intervention on side bracnches excluding the use of compression stockings. Intraoperative pain was assessed using a standard Visual Analog Scale (VAS). The effectiveness of the treatment was assessed by its anatomical success in target vein occlusion, the safety of the procedure was characterized by the absence of complications. Occlusion rate was assessed by Kaplan-Mayer method and patients’ quality of life was measured by AVVQ.
Results. Between 2021 and 2024, CAC was performed in 11 patients (20 lower extremities and 23 venous trunks) – 9 women (82%) and 2 men (18%). Their mean age was 59.2±15.4 years. The distribution of patients according to CEAP was: C2 – 6 (54%); C3 – 1 (9%), C4 – 4 (36%) and C6 – 1 (9%). The mean diametre of the GSV was 10.1±3.6 mm, the diametres of the SSV and the AASV were 9.8±3.5 mm and 8.5±0.7 mm respectively. The control duplex ultrasound was performed on the 3rd day, 1st and 3rd months after the intervention. Vein occlusion on the 30th day was achieved in all 100% of patients. Recanalization of the target veins during the follow-up period was noted in 1 patient (4% of all treated veins). In 1 (9%) patient, one truncal vein was ablated, in 7 (63%) – two and in 2 (18%) patients – three trunks were ablated simultaneously. The mean intervention time comprised 55.9± 9.7 minutes. Intraoperative VAS in 93% of patients was less than 3 points. Migration of glue with its propagation into the deep vein was detected in 1 patient (4%), the formation of soft tissue granuloma was noted in 1 patient (4% of all treated veins). Phlebitic skin reaction was registered within 7 to 21 days after the intervention in 2 (18%) patients. There were no cases of paresthesia, deep or superficial vein thrombosis, nor PE in our patients.
Сonclusion. CAC has shown high efficacy and safety in our group of patients with occlusion rate of up to 90% in 3 year period.
Keywords: varicose veins, cyanoacrylate adhesive closure, glue ablation, mid-term results.
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