Objective To review clinical outcomes of varicose vein patients treated with cyanoacrylate embolization and radiofrequency ablation at our institution. Methods A retrospective review of patients who underwent cyanoacrylate embolization and radiofrequency ablation during a three-year period. Patient records were reviewed to assess demographics, location and severity of disease, treatment details and outcome at short- and mid-term follow-ups. Outcome parameters included treatment success and complications. Results Between January 2014 and December 2016, 335 patients with 476 veins were treated with either cyanoacrylate embolization (n = 148) or radiofrequency ablation (n = 328) at the Vancouver General Hospital Vascular Surgery Vein Clinic. The average age of patients were 57 ± 1 years with the majority being female (78%) and an average BMI of 24.8 ± 0.5. CEAP classes were 2 (49%), 3 (26%), 4a (22%) and >4b (3%). Of the veins treated with cyanoacrylate embolization, the vein types were as follows: 76% were great saphenous vein, 16% were small saphenous vein, 5% were anterior accessory great saphenous vein and 1.4% were perforator veins. The vein types for radiofrequency ablation were 88%, 9%, 3% and 0%, respectively. The average amount of cyanoacrylate embolization delivered for great saphenous vein treatment was 1.8 ± 0.1 ml with a treatment length of 43 ± 1 cm. Subgroup comparison was done for great saphenous vein segments. Treatment success was 100% in cyanoacrylate embolization and 99% in radiofrequency ablation. Superficial phlebitis was the most common complication noted at mid-term follow-up in 5% of cyanoacrylate embolization and 16% of radiofrequency ablation treatments (P < 0.05). One patient in each group had asymptomatic proximal thrombus extension treated with anticoagulation for 2-3 weeks. Three superficial infections from glue clumps were noted in the cyanoacrylate embolization group requiring excision and drainage. Five patients in the radiofrequency ablation group had persistent numbness and one wound complications at the access site. Conclusion Cyanoacrylate embolization offers equivalent success rates with lower mid-term complication rates as radiofrequency ablation.
Objective: The objective of this study was to compare clinical outcomes of cyanoacrylate (CA) and radiofrequency ablation (RFA) in the treatment of varicose veins at our institution.Methods: Between January 2014 and December 2016, there were 335 patients with 476 venous segments who were treated with either CA (n ¼ 148) or RFA (n ¼ 328) for varicose veins at the Vancouver General Hospital vascular clinic. Charts were reviewed to assess demographics of the patients, location and severity of disease, treatment details, and outcome at short-term and midterm follow-ups. Outcome parameters included treatment success and presence of short-term and midterm complications.Results: The average age of patients was 57 6 1 years, with the majority being female (78%) and with an average body mass index of 24.8 6 0.5. Clinical, Etiology, Anatomy, and Pathophysiology classes were 2 (49%), 3 (26%), 4a (22%), and >4b (3%). Of the 148 segments treated with CA, the vein types were as follows: 112 great saphenous veins (GSVs), 24 small saphenous veins, 2 accessory GSVs, and 8 perforator veins. The average amount of CA delivered for GSV treatment was 1.8 6 0.1 mL, with a treatment length of 43 6 1 cm. Subgroup comparison was done for GSV segments. Treatment success was 100% in CA and 99% in RFA. Superficial phlebitis was the most common complication noted at midterm follow-up in 5% of CA and 16% of RFA treatments. There was one patient in each group who had asymptomatic proximal thrombus extension treated with anticoagulation for 2 weeks. Three superficial glue protrusions requiring minor incision and drainage were noted in the CA group. Five patients in the RFA group had persistent numbness and two had nonhealing wounds at the access site.Conclusions: CA is a minimally invasive endovenous technique for treating varicose veins without the need of tumescent analgesia. In our experience, CA offers success rates equivalent to RFA with lower midterm complication rates.
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