Ali İhsan Tekin
Department of Cardiovascular Surgery, Health Sciences University Kayseri City Hospital, Kayseri, 38020 Turkey
Introduction: Varicose veins in the great saphenous vein (GSV) are common and have significant impact on the quality of life of the patients. Minimally invasive cyanoacrylate embolization, which uses a liquid biocompatible glue and compression in order to anneal the walls of the dilated vein, is a relatively recent approach for the treatment of the condition. Previously, we reported the six-month outcomes of a prospective study and herein we present the results of the two-year follow-ups for the procedures including those in the previous study and evaluate the long-term efficacy of the vein sealing system using VariClose®.
Materials and methods: The prospective study involved the treatment of a total of 73 patients for incompetent GSVs and their follow-up examinations. The site of reflux, patients’ suitability for endovenous treatment, and closure of varicosities at the first week, the sixth month, and the first and second years after the procedure were determined with pre-operative duplex ultrasound. The status of veins was classified according to the Clinical-Etiology-Anatomy-Pathophysiology (CEAP) classification. Clinical success of the treatment was evaluated with venous clinical severity score (VCSS).
Results: Total occlusion in the treated segment was achieved in all patients at week one but decreased to 93.2% at the end of postoperative sixth month and 90.4% and 87.7% at the end of first and second year, respectively. Varicosities of all the patients were resolved, and all of the patients experienced an improvement in their symptoms postoperatively as indicated by decreased CEAP classification and VCSS. Hematoma (in two patients, 2.7%) and phlebitis (in three patients, 4.1%) were observed as rare adverse events.
Conclusion: The system used in this study delivered comparable venous occlusion rates and clinical improvements to those of thermal ablation methods and other cyanoacrylate-based vein sealing systems available in the market.
varicose veins, great saphenous vein, n-butyl cyanoacrylate, cyanoacrylate embolization.