A new percutaneous technique: N-butyl cyanoacrylate adhesive for the treatment of giant saphenous vein insufficiency

Vascular ◽  
2017 ◽  
Vol 26 (2) ◽  
pp. 194-197 ◽  
Author(s):  
Mehmet Senel Bademci ◽  
Kaptanıderya Tayfur ◽  
Gökhan Ocakoglu ◽  
Serkan Yazman ◽  
Muhammet Akyüz ◽  
...  
Keyword(s):  
Saphenous Vein ◽  
Varicose Vein ◽  
Severity Score ◽  
Early Period ◽  
Duplex Ultrasound ◽  
Clinical Severity ◽  
Tumescent Anesthesia ◽  
Clinical Severity Score ◽  
Venous Clinical Severity Score ◽  
Vein Insufficiency

Background We have made a retrospective evaluation of the results of the cyanoacrylate ablation technique which has recently started to be used in the treatment of giant saphenous vein insufficiency today and in which tumescent anesthesia is not required. Methods Giant saphenous vein was treated in 50 patients between September 2015 and September 2016 by using endovenous cyanoacrylate ablation. In the procedure, tumescent anesthesia and varsity socks were not used. Control duplex ultrasound evaluation was performed in the post-procedural 1st, 6th and 12th months. Venous Clinical Severity Score and Aberdeen Varicose Vein Questionnaire scores were evaluated. Results In the 50 patients who were treated, full closure was observed in giant saphenous vein in 47 (94%) patients in the 12th month control duplex ultrasound. The mean age of the patients was 46.4 (20–70) and 30 (60%) of them were female. The median Venous Clinical Severity Score scores in the 1st, 6th and 12th months were 3, 2 and 1, respectively ( p < 0.001); the median Aberdeen Varicose Vein Questionnaire scores in the 1st, 6th and 12th months were 7, 5 and 4, respectively ( p < 0.001). In the access site, two (4%) patients developed phlebitis and one (2%) developed ecchymosis. However, deep venous thrombosis, pulmonary embolism and paresthesia were not observed. Conclusion Considering the early period results in the treatment of giant saphenous vein insufficiency, cyanoacrylate ablation makes a more reliable alternative than endovenous thermal ablation methods in that it does not require tumescent anesthesia and it has a low incidence of adverse effects.

Need for adjunctive procedures following cyanoacrylate closure of incompetent great, small and accessory saphenous veins without the use of postprocedure compression: Three-month data from a postmarket evaluation of the VenaSeal System (the WAVES Study)

2018 ◽  
Vol 34 (4) ◽  
pp. 231-237 ◽  
Author(s):  
Kathleen Gibson ◽  
Renee Minjarez ◽  
Krissa Gunderson ◽  
Brian Ferris
Keyword(s):  
Saphenous Vein ◽  
Varicose Vein ◽  
Severity Score ◽  
Rating Scale ◽  
Great Saphenous Vein ◽  
Clinical Severity ◽  
Compression Stockings ◽  
Saphenous Veins ◽  
Clinical Severity Score ◽  
Venous Clinical Severity Score

Purpose Studies examining cyanoacrylate closure of saphenous veins with the VenaSeal™ System have not allowed concomitant procedures for tributaries at the time of the index procedure. Outside of clinical trials, however, concomitant procedures are frequently performed in conjunction with endovenous ablation. We report on the frequency of need for saphenous tributary treatment three months after cyanoacrylate closure of the treatment of great saphenous vein, small saphenous vein, and/or accessory saphenous vein. Methods Fifty subjects with symptomatic great saphenous vein, small saphenous vein, and/or accessory saphenous vein incompetence were treated with no postprocedure compression stockings. Concomitant procedures were not allowed. Treating physicians predicted the type and nature of any concomitant procedures that they would usually perform at the time of ablation, if not limited by the constraints of the study. Evaluations were performed at one week, one and three months and included duplex ultrasound, numeric pain rating scale, revised venous clinical severity score, the Aberdeen Varicose Vein Questionnaire, and time to return to work and normal activities. At the three-month visit, the need for and type of adjunctive procedures were recorded. Results Complete closure at three months was achieved in 70 (99%) of the treated veins (48 great saphenous veins, 14 accessory saphenous veins, eight small saphenous veins). Revised venous clinical severity score improved from 6.4 ± 2.2 to 1.8 ± 1.5 (P < .001) and Aberdeen Varicose Vein Questionnaire from 17.3 ± 7.9 to 6.5 ± 7.2 (P < .0001). Sixty-six percent of patients underwent tributary treatment at three months. The percentage of patients who required adjunctive treatments at three months was lower than had been predicted by the treating physicians (65% versus 96%, p=.0002). Conclusions Closure rates were high in the absence of the use of compression stockings or side branch treatment. Improvement in quality of life was significant, and the need for and extent of concomitant procedures was significantly less than had been predicted by the treating physicians.

A retrospective study of a new n-butyl-2-cyanoacrylate glue ablation catheter incorporated with application guiding light for the treatment of venous insufficiency: Twelve-month results

Vascular ◽  
2018 ◽  
Vol 26 (5) ◽  
pp. 547-555 ◽  
Author(s):  
Turhan Yavuz ◽  
Altay Nihat Acar ◽  
Huseyin Aydın ◽  
Evren Ekingen
Keyword(s):  
Saphenous Vein ◽  
Varicose Vein ◽  
Severity Score ◽  
Great Saphenous Vein ◽  
Clinical Severity ◽  
The Third ◽  
Clinical Severity Score ◽  
Venous Clinical Severity Score ◽  
The Mean

Objective This study aims to present the early results of a retrospective study of the use of novel n-butyl-2-cyanoacrylate (VenaBlock)-based nontumescent endovenous ablation with a guiding light for the treatment of patients with varicose veins. Methods Patients with lower limb venous insufficiency were treated with n-butyl-2-cyanoacrylate (VenaBlock Venous Closure System) between April 2016 and July 2016. The study enrolled adults aged 21–70 years with symptomatic moderate to severe varicosities (C2–C4b) and great saphenous vein reflux lasting longer than 0.5 s with great saphenous vein diameter between 5.5 and 15 mm assessed in the standing position. No compression stockings were used after the procedure. Duplex ultrasound imaging and clinical follow-up were performed on the third day, first month, sixth month, and 12th month. Clinical, etiological, anatomical, pathophysiological classification; venous clinical severity score; and completed Aberdeen varicose vein questionnaire were recorded. Results Five hundred thirty-eight patients with great saphenous vein incompetency underwent n-butyl-2-cyanoacrylate ablation. The mean ablation length was 25.69 ± 4.8 cm, and the average amount of n-butyl-2-cyanoacrylate delivered was 0.87 ± 0.15 ml. The mean procedure time was 11.7 ± 4.9 min. Procedural success was 100%, and complete occlusion was observed after treatment and at the third-day follow-up. We observed ecchymosis in five patients (1.00%) at the entry site at the third-day follow-up. Phlebitis was encountered with six (1.20%) patients. No skin pigmentation, hematoma, paresthesia, deep vein thrombosis, or pulmonary embolism was observed. Kaplan–Meier analysis yielded an occlusion rate of 99.4% at the 12-month follow-up. All patients had significant improvement in venous clinical severity score and Aberdeen varicose vein questionnaire scores postoperatively ( p <0.0001). Venous clinical severity score scores decreased from 5.43 ± 0.87 to 0.6 ± 0.75. Aberdeen varicose vein questionnaire scores decreased from 18.32 ± 5.24 to 4.61 ± 1.42. Conclusions The procedure appears to be feasible, safe, and efficient in treating the great majority of incompetent great saphenous veins with this technique.

scholarly journals The utility of the venous clinical severity score in 682 limbs treated by radiofrequency saphenous vein ablation

2007 ◽  
Vol 45 (5) ◽  
pp. 1008-1015.e2 ◽  
Author(s):  
Michael A. Vasquez ◽  
Jiping Wang ◽  
Marchyan Mahathanaruk ◽  
Glenn Buczkowski ◽  
Esther Sprehe ◽  
...  
Keyword(s):  
Saphenous Vein ◽  
Severity Score ◽  
Clinical Severity ◽  
Clinical Severity Score ◽  
Venous Clinical Severity Score

A prospective comparison of a new cyanoacrylate glue and laser ablation for the treatment of venous insufficiency

2016 ◽  
Vol 31 (1_suppl) ◽  
pp. 106-113 ◽  
Author(s):  
Ahmet Kürşat Bozkurt ◽  
Muhammet Fatih Yılmaz
Keyword(s):  
Laser Ablation ◽  
Varicose Vein ◽  
Severity Score ◽  
Venous Insufficiency ◽  
Clinical Severity ◽  
Cyanoacrylate Glue ◽  
Endovenous Laser Ablation ◽  
Clinical Severity Score ◽  
Venous Clinical Severity Score ◽  
One Year

Introduction Cyanoacrylate ablation is the newest nonthermal vein ablation technique. The one-year results of a prospective comparative study of a new cyanoacrylate glue versus endovenous laser ablation for the treatment of venous insufficiency is presented. Material and methods A total of 310 adult subjects were treated with cyanoacrylate ablation or endovenous laser ablation. The primary endpoint of this study was complete occlusion of the great saphenous vein. Secondary endpoints were procedure time, procedural pain, ecchymosis at day 3, adverse events, changes from baseline in Venous Clinical Severity Score, and Aberdeen Varicose Vein Questionnaire. Results Operative time was shorter (15 ± 2.5 versus 33.2 ± 5.7, <0.001), and periprocedural pain was less (3.1 ± 1.6 versus 6.5 ± 2.3, <0.001) in cyanoacrylate ablation group compared to the endovenous laser ablation group. Ecchymosis at the third day was also significantly less in cyanoacrylate ablation group (<0.001). Temporary or permanent paresthesia developed in seven patients in endovenous laser ablation group and none in cyanoacrylate ablation group (p = 0.015). One, three, and 12 months closure rates were 87.1, 91.7, and 92.2% for endovenous laser ablation and 96.7, 96.6, and 95.8% for cyanoacrylate ablation groups. Closure rate at first month was significantly better in cyanoacrylate ablation group (<0.001). Although there is a trend of better closure rates in cyanoacrylate ablation patients, this difference did not reach to the statistical difference at sixth and 12th month (p = 0.127 and 0.138, respectively). Both groups had significant improvement in Venous Clinical Severity Score and Aberdeen Varicose Vein Questionnaire postoperatively (<0.001), but there was no significant difference in Venous Clinical Severity Score and Aberdeen Varicose Vein Questionnaire scores between the groups at first, sixth, and 12 months. Only a slightly better well-being trend was noted in cyanoacrylate ablation group in terms of Aberdeen Varicose Vein Questionnaire scores (p = 0.062). Conclusions The efficacy and safety analysis shows that cyanoacrylate ablation is a safe, simple method which can be recommended as an effective endovenous ablation technique. The follow-up data more than one year will clarify the future role of cyanoacrylate ablation for the treatment incompetent great saphenous veins.

Two-year follow-up of a n-butyl-2-cyanoacrylate glue ablation for the treatment of saphenous vein insufficiency with a novel application catheter with guiding light

Vascular ◽  
2019 ◽  
Vol 27 (4) ◽  
pp. 352-358
Author(s):  
Atilla Sarac
Keyword(s):  
Saphenous Vein ◽  
Severity Score ◽  
Venous Insufficiency ◽  
Great Saphenous Vein ◽  
Clinical Severity ◽  
The Third ◽  
Clinical Severity Score ◽  
Venous Clinical Severity Score ◽  
The Mean

Objectives This study aims to present the early results of a prospective study of the use of novel n-butyl-2 cyanoacrylate (VenaBlock)-based nontumescent endovenous ablation with a guiding light for the treatment of patients with varicose veins. Methods Five hundred and seventy-three patients with lower-limb venous insufficiency were treated within in the previous four years. The study enrolled adults aged 21–70 years with symptomatic moderate to severe varicosities (C2–C6 patients clinical, etiological, anatomical, and pathophysiological classification) and great saphenous vein reflux lasting longer than 0.5 s with great saphenous vein diameter ≥ 5.5 mm assessed in the standing position. Duplex ultrasound imaging and clinical follow-up were performed on the third day, first month, and sixth month. Clinical, etiological, anatomical, pathophysiological classification; venous clinical severity score; and completed Aberdeen varicose vein questionnaire were recorded. Results Five hundred and seventy-three patients aged 21–70 years with lower-extremity venous insufficiency treated with n-butyl-2. The mean treatment length was 30.6 ± 5.3 cm and the average n-butyl-2 delivered was 1.2 ± 0.3 ml. The mean procedure time was 10.8 ± 4.7 min. There was no deep venous thrombosis, pulmonary embolism, or paresthesia. We observed ecchymosis in eight patients (1.4%) at the entry site at the third day follow-up. Phlebitis was encountered with 10 (1.8%) patients. No skin pigmentation, hematoma, paresthesia, deep-vein thrombosis, or pulmonary embolism was observed. Procedural success was 100%, and complete occlusion was observed after treatment, at the third day follow-up and at first month. Kaplan–Meier analysis yielded with overall clinical recurrence-free rate after a mean follow-up of 23.96 months was 99.38%. All patients had significant improvement in venous clinical severity score and quality-of-life scores postoperatively ( p < 0.0001). Venous clinical severity score scores at preintervention and 24th month were 5.8 ± 1.0 (range 4–8) and 0.6 ± 0.6 (range 0–4), respectively ( p < 0.0001). Aberdeen varicose vein questionnaire scores at preintervention and 24th month were 19.7 ± 6.4 (range 9–30) and 4.4 ± 1.1 (range 1–9), respectively ( p < 0.0001). Conclusions The procedure appears to be feasible, safe, and efficient in treating the great majority of incompetent great saphenous veins with this technique.

Responsiveness of individual questions from the venous clinical severity score and the Aberdeen varicose vein questionnaire

2012 ◽  
Vol 29 (1) ◽  
pp. 43-51 ◽  
Author(s):  
C R Lattimer ◽  
E Kalodiki ◽  
M Azzam ◽  
G Geroulakos
Keyword(s):  
Varicose Vein ◽  
Severity Score ◽  
Poor Response ◽  
Clinical Severity ◽  
Foam Sclerotherapy ◽  
Endovenous Laser Ablation ◽  
Clinical Severity Score ◽  
Venous Clinical Severity Score ◽  
Pre Treatment ◽  
The Individual

Objectives The venous clinical severity score (VCSS) and the Aberdeen varicose vein questionnaire (AVVQ) improve after treating chronic venous insufficiency (CVI). The aim was to examine how and why they improve by evaluating the change in each individual question. Methods This was an analysis on prospectively collected data from a clinical study on 100 patients (58% female) with CVI (C2 = 34, C3 = 14, C4a = 29, C4b = 9, C5 = 7, C6 = 7) who were randomized to endovenous laser ablation ( n = 50) or foam sclerotherapy ( n = 50). The change scores (performance) of each question of the VCSS (questions 1–10) and the AVVQ (questions 1–13) were calculated by subtracting the score at three weeks, and three months, from the pre-treatment score. Results Both the median, interquartile range (IQR), VCSS and the AVVQ scores improved from 6 (4) and 21.4 (15.1) at baseline to 3 (4) and 18.6 (12.1) at three weeks ( P < 0.0005, P = 0.031) to 2 (3) and 8.8 (13.6) at three months, ( P < 0.0005, P < 0.0005), respectively. The performance of the first three questions of the VCSS (pain, extent of varicosities, oedema) were the most contributory to the overall score. Questions 5, 7, 8, 9 on ulceration improved the most individually but did not contribute significantly to the overall score. Questions 5, 9 of the AVVQ on stocking use and ulceration failed to contribute statistically to the overall improvement at three months. Conclusion The majority of the individual questions of the VCSS and AVVQ responded to change. However, the cause of a poor response was multifactorial with statistical dilution playing a significant role. Stratification of patients according to ulceration may allow better comparisons.

Comparison of high saphenous ligation and stripping, radiofrequency ablation, and subfascial endoscopic perforator surgery for the treatment of active venous ulcers: Retrospective cohort with five-year follow-up

Vascular ◽  
2021 ◽  
pp. 170853812110113
Author(s):  
Yusuf Kuserli ◽  
Ali Aycan Kavala ◽  
Saygin Turkyilmaz
Keyword(s):  
Radiofrequency Ablation ◽  
Saphenous Vein ◽  
Severity Score ◽  
Great Saphenous Vein ◽  
Clinical Severity ◽  
Venous Ulcers ◽  
Vein Occlusion ◽  
Clinical Severity Score ◽  
Venous Clinical Severity Score ◽  
Subfascial Endoscopic Perforator Surgery

Objective To compare the use of high saphenous ligation and stripping, radiofrequency ablation, and subfascial endoscopic perforator surgery for the treatment of active venous ulcers. Methods One hundred ninety-five ( n = 195) subjects who were treated for venous leg ulcers were enrolled between 2009 and 2014. Three groups were formed (Group A: high saphenous ligation and total stripping, Group B: radiofrequency ablation of the great saphenous vein + perforators, and Group C: radiofrequency ablation of the great saphenous vein + subfascial endoscopic perforator surgery) ( n = 65 for each group). The venous clinical severity score for baseline, 1st, 6th, and 12th months, great saphenous vein occlusion at the 1st, 6th, and 12th months, and ulcer rates for the 1st, 2nd, 3rd, 4th, and 5th years were recorded. Results For venous clinical severity score, only the first month decrease was significant for the subfascial endoscopic perforator surgery group ( p = 0.001). Great saphenous vein occlusion was higher at the 6th and 12th months for the high saphenous ligation and stripping and subfascial endoscopic perforator surgery groups than for the radiofrequency ablation group ( p = 0.036 and p = 0.037). The rate of ulcers for the subfascial endoscopic perforator surgery group was lower at the second, third, fourth, and fifth years ( p = 0.011). No significant difference was found between groups for the five-year recovery rates ( p > 0.05). Conclusion Subfascial endoscopic perforator surgery technique in conjunction with radiofrequency ablation of axial vein was superior to both high saphenous ligation and stripping and radiofrequency ablation of axial and perforators for ulcer healing.

scholarly journals Determinants and patterns of recurrence of primary varicose veins after Endovenous laser ablation

2020 ◽  
Author(s):  
Sheref A. Elseidy ◽  
M. Hatem ◽  
Ahmed K. Awad ◽  
Obaie Mzaik ◽  
Debvarsha Mandal ◽  
...  
Keyword(s):  
Laser Ablation ◽  
Saphenous Vein ◽  
Varicose Vein ◽  
Varicose Veins ◽  
Duplex Ultrasound ◽  
Clinical Severity ◽  
Endovenous Laser Ablation ◽  
Venous Clinical Severity Score ◽  
Table Analysis ◽  
Lost To Follow Up

Abstract Background: The goal of this retrospective cohort study was to determine the different recurrence patterns, sites and determinants impacting primary varicose vein recurrence after endovenous laser ablation (EVLA).Methods: 127 symptomatic patients (127 limbs) with great saphenous vein incompetence who underwent EVLA were followed up for recurrence. Twenty-seven patients were lost to follow-up, leaving 100 patients (100 limbs) for analysis. Outcomes: Recurrence defined by venous clinical severity score (VCSS) or patterns of reflux on the duplex ultrasound examination. Assessments were done at 1, 6, 12 and 24 months after the procedure.Results: Two-year life table analysis showed varicose vein recurrence in 9(7.1%) of limbs. Varicose vein recurrence was due to refluxing anterior accessory saphenous vein in 77.8% patients (p <0.001, 95% CI 3.2 to 1669.1), re-canalization (66.6%), non-truncal varicosities (55.5 %) and incompetent perforators 77.8% patients (p <0.001, 95% CI 2.7 to 69.3).Recurrence was mostly seen owed to both incompetent perforators and accessory saphenous vein, BMI more than 30.5 kg/m2 is noted in 77.8 % (p <0.001, 95% CI 1.105 to 1.590) of recurrence patients.

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