[Adverse events and complications following cyanoacrylate adhesive closure of varicose veins].

Background: Cyanoacrylate adhesive closure is currently considered to be an alternative to thermal ablation of varicose veins. It emerged as a natural step towards minimally invasive surgical treatment of incompetent saphenous veins.

Objective: The purpose of this study was to assess the safety of cyanoacrylate adhesive closure in treatment of patients with varicose veins based on two-year experience.

Patients and methods: Between July 2019 and July 2021, cyanoacrylate adhesive closure was performed in a total of 457 patients (634 limbs and 725 venous trunks). The inclusion criteria were as follows: CEAP clinical classes C2-C6, junctional and truncal valve incompetence with reflux >0.5 sec, saphenous vein diameter > 6 mm, presence of varicosities. Cyanoacrylate adhesive closure was carried out according to the standard VenaSeal protocol. In 76.2% of cases, the procedure was performed selectively without tributary treatment. Duplex ultrasound follow-up examinations were carried out on POD 3, as well as at 1, 3, 6 and 12 months following the procedure.

Results: Partial recanalization occurred in 4 (0.8%) cases between 6 and 15 months post-procedure. Glue migration and propagation into the deep vein was detected in 7 (1.5%) patients and asymptomatic sural vein thrombosis was found in 2 (0.4%) cases. Phlebitis-like skin reaction developed in 50 (11%) cases, superficial thrombophlebitis - in 20 (4.3%) patients. In 6 (1.3%) cases, the procedure was complicated by soft tissue foreign body granuloma. There were no cases of either pulmonary embolism or peripheral neuropathy.

Conclusion: The procedure of cyanoacrylate adhesive closure proved highly effective and safe in treating patients with superficial venous insufficiency and was associated with minimal incidence of adverse events during the two-year follow-up. Further studies are needed to assess the long-term safety of the method.