Cyanoacrylate Adhesive Closure in the Real-World Practice: 2-Year Results of Varicose Vein Treatment

Abstract

Introduction. Over the past decade, thermal tumescent (TT) ablation became the “gold standard” treatment of varicose veins. Non-thermal non-tumescent (NTNT) methods emerged in response to minimize the interventional invasion.Aim. To evaluate the two-year results of cyanoacrylate adhesive closure (CAC).Methods. Between July 2019 and July 2021, CAC was performed in 457 patients (average age 57.8 ± 15.7 years), on 634 limbs and 725 saphenous veins. Patient distribution according to CEAP was: C2 – 38%; C3 – 37%; C4 – 19%; C5 – 4%; C6 – 2%. The inclusion criteria were: incompetence of sapheno-femoral/popliteal junction and axial reflux > 0.5 sec, diameter of saphenous trunk > 6 mm, presence of varicosities. CAC was performed according to the protocol of the American Vein Closure System In more than 2/3 of cases (76.2%), CAC was performed selectively without tributary treatment . The pain was assessed by visual-analogue scale (VAS). The control ultrasound was performed on the 3rd day, 1, 3, 6, and 12 months post-intervention.Results. Anatomical success was achieved in 100%. The VAS pain score was < 3 in 93% of patients. Partial recanalization occurred in 4 (0.6%) patients. Distal deep vein thrombosis was detected in 2 (0.3%) patients, migration of glue – in 7 (1%) patients, phlebitislike skin reaction – in 50 (11%), superficial thrombophlebitis – in 20 (4.4%) and soft tissue granuloma at the access site was diagnosed in 6 (1.3%) patients.Conclusion. CАC is a highly effective and safe treatment method with 99.4% occlusion rate in s. two-year follow-up period.