Saphenous vein ablation with a new cyanoacrylate glue device: a systematic review on 1000 cases

Bissacco, Daniele; Stegher, Silvia; Calliari, Fabio Massimo; Viani, Marco Piercarlo

doi:10.1080/13645706.2018.1464029

Cited by 43 publications

(37 citation statements)

References 25 publications

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“…1 Cyanoacrylate glue also appears to be a safe method of treatment, with a low rate of complications reported in clinical studies. 6 Reported complications are typically mild and managed either conservatively or on an outpatient basis and include pain, thrombophlebitis, cellulitis, skin hyperpigmentation and deep vein thrombosis. 7,8 However, clinical studies currently published do not have large patient cohorts, leading to the reasonable concern that they are underpowered to detect rare complications.…”

Section: Discussionmentioning

confidence: 99%

Cyanoacrylate glue embolisation for varicose veins – A novel complication

et al. 2020

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Background Non-thermal non-tumescent methods for varicose vein treatment have rapidly gained popularity in recent years due to clinical efficacy comparable to other endovenous methods, but with a superior safety and tolerability profile. Cyanoacrylate is an adhesive that rapidly polymerises during endovenous treatment to cause rapid occlusion of veins and initiate vein fibrosis. Method Cyanoacrylate glue treatment is known to cause complications such as phlebitis, cellulitis and deep vein thrombosis in rare instances. We present the first reported case of cyanoacrylate extravasation with chronic foreign body reaction in a patient nine months after initial treatment. Results We discuss the aetiology of this complication, its treatment, patient outcome and its significance to both clinicians and patients. Conclusion Cyanoacrylate glue embolisation can, in rare instances, lead to extravasation and chronic foreign body reaction, necessitating surgical intervention. The relative novelty of cyanoacrylate glue embolisation in the treatment of varicose veins requires clinicians to monitor for rare complications during its use in clinical practice. Patients should be aware of the rare risk of glue extravasation and foreign body reaction for fully informed consent prior to treatment.

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Section: Discussionmentioning

confidence: 99%

Cyanoacrylate glue embolisation for varicose veins – A novel complication

et al. 2020

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“…25,26,30 Bissacco et al reviewed 1,000 NBCA cases in seven studies (two prospective, four retrospective) and found 96.8% of veins occluded at 12 months. 38 Two studies reported NBCA occlusion beyond the 2-year interval, and these were 94.1% at 30 months and 94.7% at 36 months, respectively. 20,28 Time to complete occlusion was shorter for NBCA than any of the endothermal modalities because veins are instantly occluded by approximation of their intima, while thermal ablation is dependent on vein wall destruction and subsequent fibrosis-a biological process which takes longer.…”

Section: Discussionmentioning

confidence: 97%

“…A meta-analysis would have been ideal but as highlighted in a recent article, the scarcity and heterogeneity of RCTs made this difficult. 38 As most patients were not sedated, double blinding was impossible. Outcome assessors were often the same ones recruiting, carrying out the treatments and/or following-up patients.…”

Section: Discussionmentioning

confidence: 99%

Efficacy of Cyanoacrylate Glue Ablation of Primary Truncal Varicose Veins Compared to Existing Endovenous Techniques: A Systematic Review of the Literature

Dimech

Cassar

2020

Surg J (N Y)

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Abstract Introduction One-third of adults in the United States and United Kingdom suffer from varicose veins. n-butyl-2-cyanoacrylate (NBCA) glue is a novel endovascular, nontumescent, nonthermal ablation technique for treatment of this condition. It has proved effective in multiple studies since its first use in 2013. The aim of this systematic review is to assess the efficacy of NBCA in ablating primary truncal varicose veins and eliminating reflux compared with existing endovascular techniques. Secondary outcomes include complications and quality of life. Methods PRISMA was used as a guide and studies were screened for risk of bias and methodological quality. Subjects had to be ≥18 years of age and followed-up posttreatment with color Duplex ultrasound (DUS). Eligibility criteria included saphenofemoral junction (SFJ) or saphenopopliteal junction (SPJ) incompetence with reflux down truncal veins lasting >0.5 seconds on DUS interrogation and a Clinical, Etiological, Anatomical, and Pathophysiological classification of venous disorders ranging between C1 and C6. Results Out of 2,910 patients (3,220 veins) in 17 studies, 1,981 were administered NBCA, 445 radiofrequency ablation (RFA), and 484 endovenous laser ablation (EVLA) with mean procedure times of 25.7, 23.2, and 28.7 minutes, respectively. Mean recruitment period was 9 months (1–36 months) and followed-up for an average of 12.3 months (1–36 months). The majority were C2 to C3. Two-year occlusion rates were 93.7, 90.9, and 91.5% for NBCA, RFA, and EVLA, respectively. NBCA-treated patients experienced the least complications, with bruising, phlebitis, and pain being the most prevalent. Quality of life improved equally in all three modalities. Conclusion NBCA is simple to administer, safe, and effective even without compression stockings. Further studies are required to assess longer-term benefit and the effect of anticoagulation on vein obliteration.

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“…In particular, occlusion rates remain quite similar to those seen in a recent systematic review including non-RCT studies (six month occlusion rate 97.3% in the systematic review vs. 98.1% in the RCT; one year occlusion rate 97.0% in the systematic review vs. 94.7% in this RCT). 2 Conversely, there were more post-operative complications in the RCT than in the systematic review (ecchymosis 5.4% vs. 0.8% and phlebitis 6.5% vs. 1.9%, respectively). Despite differences in results among studies, this RCT confirms encouraging outcomes for NBCA for uncomplicated (C2 C4) patients with GSV incompetence.…”

mentioning

confidence: 81%

Re: “A Randomised Clinical Trial Comparing N-Butyl Cyanoacrylate, Radiofrequency Ablation and Endovenous Laser Ablation for the Treatment of Superficial Venous Incompetence: Two Year Follow up Results”

Bissacco

Stegher

Calliari

et al. 2019

European Journal of Vascular and Endovascular Surgery

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Saphenous vein ablation with a new cyanoacrylate glue device: a systematic review on 1000 cases

Abstract: NBCA injection with the Variclose device seems to be a feasible, effective and safe treatment in GSV incompetence. Long-term follow-up studies and randomized controlled trials are needed to achieve high-quality evidence.

Cited by 43 publications

References 25 publications

Cyanoacrylate glue embolisation for varicose veins – A novel complication

Cyanoacrylate glue embolisation for varicose veins – A novel complication

Efficacy of Cyanoacrylate Glue Ablation of Primary Truncal Varicose Veins Compared to Existing Endovenous Techniques: A Systematic Review of the Literature

Re: “A Randomised Clinical Trial Comparing N-Butyl Cyanoacrylate, Radiofrequency Ablation and Endovenous Laser Ablation for the Treatment of Superficial Venous Incompetence: Two Year Follow up Results”

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