Systematic review and meta-analysis of endovenous cyanoacrylate adhesive ablation for incompetent saphenous veins

García-Carpintero, Esther; Carmona, Montserrat; Chalco-Orrego, Juan Pablo; González-Enríquez, Jesús; Imaz-Iglesia, Iñaki

doi:10.1016/j.jvsv.2019.09.010

Cited by 29 publications

(20 citation statements)

References 40 publications

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“…Although the results of phlebitis rates were similar with no statistically significant differences between all three studies, the pooled analysis (Figure 3(c)) indicates that the phlebitis rate of CA was significantly lower compared with EVLA. Different results were reported in a previous meta-analysis, 8 which showed no significant differences in ecchymosis (p = 0.42) and phlebitis (p = 0.15) rates between the two groups after the pooled analysis of Bozkurt’s and Eroglu’s data.…”

Section: Analysis Of Study Resultscontrasting

confidence: 69%

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A systematic review and meta-analysis comparing the efficacy of cyanoacrylate ablation over endovenous thermal ablation for treating incompetent saphenous veins

et al. 2021

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Objectives The aim of this study was to systemically review and analyze the efficacy of cyanoacrylate ablation (CA) in comparison with endovenous thermal ablation (ETA) for the treatment of incompetent saphenous veins. Methods A systematic literature search was conducted using databases of Pubmed, Embase, and Cochrane Library from the times of their inception to April 2020. Studies were selected based on inclusion and exclusion criteria after assessing the risk of bias in comparative studies with Cochrane and rating quality of evidence with the GRADE methodology. The meta-analysis was carried out using the Review Manager 5.4 program to conduct homogeneity tests. Results One cohort study and three randomized controlled trials (RCT), including a total of 1457 participants were included in the meta-analysis. ETA included endovenous laser ablation (ELVA) and radiofrequency ablation (RFA) in the selected studies. Comparison between CA and a combination of EVLA and RFA or RFA alone were carried out in two of RCTs, while comparison between CA with EVLA was conducted in one RCT and the cohort study. There was no statistical difference in closure rates between CA and ETA after pooled analysis. Similar symptom alleviation observed between different groups. However, the CA group showed a lower ecchymosis rate than RFA and a significantly lower incidence of adverse events, such as ecchymosis, phlebitis and paresthesia, than EVLA. Compared with ETA, the patients received CA treatment exhibited lower pain scores in a shorter procedure duration without needing compression stocking, returned to normal life sooner, and had significantly better quality of care. There was no significant difference in the number needed to treat for additional therapy after three months of follow-up between groups. Conclusions This meta-analysis indicates that CA has better overall outcomes than ETA and offers superior clinical benefits in the treatment of incompetent saphenous veins.

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Section: Analysis Of Study Resultscontrasting

confidence: 69%

“…The results indicate that CA treatments yield comparable effectiveness outcomes, less frequent mild adverse events, and no significant difference in major adverse events compared with EVLA and RFA. 8 After that, new study results have been reported. A more detailed and comprehensive comparison involving more participants is still needed.…”

Section: Introductionmentioning

confidence: 99%

A systematic review and meta-analysis comparing the efficacy of cyanoacrylate ablation over endovenous thermal ablation for treating incompetent saphenous veins

et al. 2021

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“…A meta-analysis of literature comparing cyanoacrylate closure to EVLA or RFA, including the VeClose trial, demonstrated no significant difference in 12-and 24-month occlusion rates between CA and RFA groups as well as no statistically significant difference in closure rates between CA and EVLA. 25 Additionally, there was no statistically significant difference in clinical symptom and quality-oflife improvement scores between CA and EVLA and CA and RFA. CA had a lower ecchymosis rate than RFA, and several trials reported higher rates of phlebitis in CA patients, although this difference was not significant.…”

Section: Comparison Of Thermal Versus Nonthermal Techniques In the Literaturementioning

confidence: 84%

Choosing the Best Treatment Approach for Axial Vein Reflux: Thermal versus Nonthermal Approaches

Shmelev

Gupta

2021

Semin intervent Radiol

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Chronic venous insufficiency is a common and treatable medical condition which has a high morbidity if left untreated, progressing to lower extremity edema, skin changes of lipodermatosclerosis, and venous ulceration. Treatment options have significantly expanded over the last several decades, shifting away from the traditional surgical approach to more minimally invasive procedures such as endoluminal venous laser ablation or radiofrequency ablation. Even more recently, several techniques using nonthermal methods to ablate varicose veins have been developed, which offer the advantage of not requiring labor-intensive and painful tumescent anesthesia to protect the surrounding tissues. These techniques include mechanochemical ablation, cyanoacrylate closure, or polidocanol microfoam injection and can be offered to a wider range of patients without the need for sedation while offering similar closure rates and improved postprocedure symptom profile. Furthermore, certain patient characteristics which might preclude or complicate the use of thermal ablation methods might not pose a problem with nonthermal nontumescent methods.

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“…Since the first approval of n-butyl cyanoacrylate for the treatment of truncal venous insufficiency in 2011, cyanoacrylate-mediated vein ablation was announced as a fast, painless and effective method in that indication [6][7][8][9][10][11][12][13][18][19][20]. The first two mentioned advantages result from no need for a time-consuming tumescent anesthesia.…”

Section: Discussionmentioning

confidence: 99%

“…High occlusion rate reported in the first VeClose trial has encouraged several manufacturers to further develop this technique [9]. Hence, in addition to slowly polymerizing, high-viscosity cyanoacrylate, VenaSeal (Medtronic, Minneapolis, MN, USA), used in the VeClose study, recently the short-chain obliterating agent named VenaBlock (Invamed Saglic Ilac A.S., Ankara, Turkey), which is characterized by its low viscosity and fast polymerization, was introduced to the market [10][11][12][13].…”

Section: Introductionmentioning

confidence: 99%

Two-Year Follow-Up after Endovenous Closure with Short-Chain Cyanoacrylate versus Laser Ablation in Venous Insufficiency

Wilczko¹,

Szary

Plucińska³

et al. 2021

JCM

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Background: The current treatment of venous disease is focused on the minimally invasive exclusion of the affected vein. Besides widely used thermal ablation, chemical ablation with cyanoacrylate, reported as safe and highly effective, has been gaining increasing interest. Patients and methods: In the current report, we present data from a two-year observation in 89 patients (61 female/28 male, mean age 44.3 ± 13.5) suffering from venous insufficiency (C2–C4), treated either using short-chain cyanoacrylate, the VenaBlock system (n = 43) or laser thermoablation with ELVeS 1470 (n = 46). The assessment comprised the occurrence of venous disease-related symptoms and the ultrasound examination of the leg venous system. Results: The frequency of recanalization after 2 years from the VenaBlock procedure was significantly higher than after laser treatment (37.2 vs. 8.7%). Apart from recanalization, in some individuals from both groups, the symptoms of recurrence and/or disease progression, including the development of insufficiency in other veins of treated or contralateral legs (9.3 vs. 15.2% and 9.3 vs. 17.4%, respectively), were observed. Unexpectedly, the general prevalence of the disease progression did not differ significantly between the VenaBlock and ELVeS groups (44.2 vs. 34.8%, respectively). Conclusions: Despite the higher recanalization rate of VenaBlock compared to ELVeS, the overall effectiveness of cyanoacrylate and laser thermoablation after two years was similar. Therefore, both methods similarly failed to prevent recurrence and disease progression, which seem to be method-independent.

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Systematic review and meta-analysis of endovenous cyanoacrylate adhesive ablation for incompetent saphenous veins

Cited by 29 publications

References 40 publications

A systematic review and meta-analysis comparing the efficacy of cyanoacrylate ablation over endovenous thermal ablation for treating incompetent saphenous veins

A systematic review and meta-analysis comparing the efficacy of cyanoacrylate ablation over endovenous thermal ablation for treating incompetent saphenous veins

Choosing the Best Treatment Approach for Axial Vein Reflux: Thermal versus Nonthermal Approaches

Two-Year Follow-Up after Endovenous Closure with Short-Chain Cyanoacrylate versus Laser Ablation in Venous Insufficiency

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