1. Treating great and small saphenous vein insufficiency with histoacryl in patients with symptomatic varicose veins and increased risk of surgery.
- Author
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Novotný K, Roček M, Pádr R, Pavlík R, Polovinčák M, Adla T, Zimolová P, Choi-Širůčková J, Weis M, Jirát S, and Rohn V
- Subjects
- Adult, Aged, Aged, 80 and over, Chronic Disease, Czech Republic, Enbucrilate adverse effects, Humans, Kaplan-Meier Estimate, Male, Middle Aged, Prospective Studies, Risk Factors, Severity of Illness Index, Time Factors, Treatment Outcome, Varicose Veins diagnostic imaging, Varicose Veins surgery, Venous Insufficiency diagnostic imaging, Venous Insufficiency surgery, Embolization, Therapeutic adverse effects, Enbucrilate administration & dosage, Endovascular Procedures adverse effects, Saphenous Vein diagnostic imaging, Saphenous Vein surgery, Varicose Veins therapy, Venous Insufficiency therapy
- Abstract
Background: Treating great and small saphenous vein trunk insufficiency with cyanoacrylate glue is the least taxing treatment method of all available techniques. Due to long-term unavailability of commercial kits with n-butyl-2-cyanoacrylate (histoacryl) in the Czech Republic, we used a modified technique., Patients and Methods: Fifty-six limbs in 49 patients suffering from great saphenous vein or small saphenous vein insufficiency in combination with symptomatic chronic venous insufficiency and complicating comorbidities were treated with a modified endovascular cyanoacrylate glue application technique., Results: The immediate success rate of the treatment was 98 %. In follow-up intervals of six weeks, six months, one year, and two years, the anatomical success rates of embolization (recanalization of no more than 5 cm of the junction) were 98, 96, 94, and 94 %, respectively. At identical intervals the venous insufficiency was scored according to the Aberdeen Varicose Vein Questionnaire and the American Venous Clinical Severity Score. In both cases, improvement was demonstrated over the two-year follow-up, with a 0.5 % significance level. Specific clinical signs of venous insufficiency were also evaluated, such as pain, oedema, clearance of varicose veins, and healing of venous ulceration. One severe complication - a pulmonary embolism - was reported, without consequences., Conclusions: We demonstrated that treating insufficient saphenous veins with modified histoacryl application brought a relief from symptoms of venous insufficiency and that the efficiency of this technique is comparable to commonly used methods.
- Published
- 2018
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