[Histological confirmation of biodegradation of 'Sulfacrylate' glue after cyanoacrylate vein ablation according to the VAGOV technique at different periods].

Background: One of the reasons for limited use of cyanoacrylate obliteration of veins is the lack of the knowledge of what happens to the glue inside the vein at different follow-up periods.

Objective: The purpose of our study was to assess the possibility and degree of biodegradation of the cyanoacrylate glue 'Sulfacrylate' after endovenous ablation according to the method of vacuum-assisted glue obliteration of veins (VAGOV) at various terms of follow up.

Patients and methods: Since 2018, we performed a total of 52 procedures of cyanoacrylate vein ablation according to the VAGOV technique. After obtaining voluntary consent, surgical biopsy of the target large saphenous vein was performed 1, 6, 12 and 24 months after the procedure. The comparison was carried out with the control vein procured after classical phlebectomy. Biological samples were stained with hematoxylin-eosin and by the Mallory method. The micro-preparations were examined using conventional light microscopy on an Axioskop 40 FL microscope (Carl Zeiss, Germany).

Results: Comparing histological sections of the great saphenous vein (GSV) harvested before surgery and 1 and 6 months after the operation according to the VAGOV technique demonstrated sequential processes of granulation tissue first, then connective tissue bearing a large number of collagen fibers inside the lumen of the GSV. At 12 and 24 months, no signs of histological recanalization of target veins were revealed. By the end of the 2-year follow-up, the replacement connective tissue completely sprouted the adhesive composition and had a typical structure (a mixture of connective tissue fibers and fibroblast cells). There was a decrease in the intensity of lymphocytic infiltration and its residual presence in the area of the former vein wall by the end of the 2-year follow-up.

Conclusion: After cyanoacrylate vein ablation according to the VAGOV technique, the adhesive composition 'Sulfacrylate' almost completely biodegraded and was replaced by connective tissue within a period of up to 24 months.