The European multicenter cohort study on cyanoacrylate embolization of refluxing great saphenous veins

Proebstle, Thomas M.; Alm, Jens; Dimitri, Sameh; Rasmussen, Lars Hvilsted; Whiteley, Mark S; Lawson, James A.; Cher, Daniel; Davies, Alun H.

doi:10.1016/j.jvsv.2014.09.001

Cited by 174 publications

(144 citation statements)

References 21 publications

(29 reference statements)

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“…We were enlightened by the new tumescent-free ablation method of a recently published two-year study by Almeida et al [14] with a 92 % closure rate, and of a recently published multi-centre study by Proebstle et al [15] in Europe with a 92.9 % closure rate. In a new comparative study by Morrison et al [16], closure rates were 99 % for cyanoacrylate embolisation compared with 96 % for RFA at three months.…”

Section: Discussionmentioning

confidence: 99%

N-butyl cyanoacrylate in the treatment of venous insufficiency - the effect of embolisation with ablative polymerisation

Çalık

Arslan

Ayaz

et al. 2016

Vasa

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Summary: Background:The primary objective of this multicentre prospective observational study was to evaluate the early results of a new non-thermal embolisation method using N-butyl cyanoacrylate in venous insuffi ciency. Patients and methods: A total of 181 patients with a varicose vein diagnosis were treated with the VariClose: Vein Sealing Systems at four different centres. The protocol included physical and colour Doppler ultrasonography examination, venous clinical severity score and quality of life assessment before and after the procedure on days 1 and 7 and at months 1, 3 and 6. Clinical recovery was evaluated by comparing the venous clinical severity score and the quality of life assessment before and after the procedure. Results: In total, 215 embolisation procedures were successfully completed on 181 patients (110 female) with a mean age of 37.6 ± 13.2 years (range 18 -72 years). The 215 procedures consisted of 25 bilateral applications on 206 great saphenous veins and 9 small saphenous veins. The average pre-interventional diameter of great saphenous veins was 6.5 ± 1.4 mm (4.3 -14 mm), and the mean diameter of small saphenous veins was 5.2 ± 1.3 mm (3.8 -8.6 mm). The average length of the sealed vein segments was 31.6 ± 6.1 cm (23 -70 cm), and the average N-butyl cyanoacrylate usage for the patient was 0.9 ml (0.7 -2.1 ml). The procedural occlusion rate was 100 %. Post-operative pain was observed in 11 patients (6.1 %), and thrombophlebitis was observed in 1 patient (0.5 %). No total recanalisation was observed. Five (2.7 %) partial recanalisations were observed at the 6 month follow-up. The 6 month total occlusion rate was 97.2 %. Conclusions: This new tumescent-free non-thermal embolisation method can be applied safely with high success rates.

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Section: Discussionmentioning

confidence: 99%

N-butyl cyanoacrylate in the treatment of venous insufficiency - the effect of embolisation with ablative polymerisation

Çalık

Arslan

Ayaz

et al. 2016

Vasa

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“…The eSCOPE study showed that CAE is safe and effective in the treatment of GSV incompetence. 54 The VeClose multicenter RCT has demonstrated that CAE is non-inferior to RFA. Among 222 patients with GSV reflux randomly assigned to receive either CAE with VenaSeal or RFA, occlusion rates were 99% for the CAE compared with RFA (96%) at 3 months follow-up.…”

Section: Cyanoacrylate Glue (Ca)mentioning

confidence: 99%

Endovenous Management of Varicose Veins

et al. 2018

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Abstract:Varicose veins are a very common condition and have been the subject of a recent proliferation of treatment modalities. The advent of the endovenous treatment era has led to a confusing array of different techniques which can be daunting when making the transition from traditional surgery. All modalities offer excellent results in the right situation and each has their own treatment profile. Thermal ablation techniques have matured and have a reassuring and reliable outcome, but the arrival of non-thermal techniques has delivered further options for both patient and surgeon. This article provides an overview of the different treatment devices and modalities available to the modern superficial vein surgeon and details the currently available evidence and summation analysis to help surgeons to make an appropriate treatment choice for their patients. Keywords:Endovenous ablation, varicose veins, venous disease, radiofrequency, sclerotherapy, cyanoacrylate Page 1 of 24 http://mc.manuscriptcentral.com/ang Angiology 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 29 30 31 32 33 34 35 36 37 38 39 40 41 42 43 44 45 46 47 48 49 50 51 52 53 54 55 56 57 58 59 IntroductionVaricose veins are a common condition affecting up to one-third of the population, with detrimental effects on the quality of life (QoL). 1-2Until the past decade, the traditional technique of saphenofemoral or saphenopopliteal ligation with or without vein stripping has been the gold standard treatment of truncal saphenous incompetence. This usually necessitates either general or regional anaesthesia. 3 Although surgery provides good outcomes, it is associated with ecchymosis, hematoma, tenderness, 4 infection, nerve injury, delayed return to normal activity 3-5 and routinely necessitates narcotic analgesia. 3In response to the need for less invasive treatment, endovenous treatments, namely radio-frequency ablation (RFA) and endovenous laser ablation (EVLA) have been developed. These have led to a reduction in morbidity compared with open surgery, 4-6 by reducing postoperative pain, providing faster recovery time, improving QoL and lowering complication rates. 7-8More recently, new non-thermal, non-tumescent (NTNTs) treatments have been developed to overcome the shortcomings associated with thermal ablation. Both thermal and non-thermal treatments are discussed in this review. Thermal-Tumescent Ablative ManagementSince 1999, endovenous thermal ablation, in the form of RFA and EVLA have been developed. More recently, endovenous microwave ablation (EMA) and steam vein sclerosis (SVS) have also been introduced. Their mechanism of action involves using heat to cause thermal damage to the venous wall. Radio-frequency ablation (RFA)The practice of RFA utilizes radio-frequency waves to produce thermal energy (85-120°C) resulting in endothelial damage and sealing of the incompetent vein ( Figure 1). In 1999, the U.S. Food and Drug Administration (FDA) approved RFA for...

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“…Nevertheless, when looking at pain scores during and along the fi rst weeks after the intervention, MOCA outperforms RSTA [57]. Treating refl uxing saphenous veins by cyanoacrylate ablation (CA) is the most recent development in non-tumescent, non-thermal ablation [58,59] which overcomes even some of the limitations of MOCA. While both, MOCA and CA do not cause paraesthesia, in contrast to MOCA, CA is lacking a dose limit, allowing the simultaneous treatment of up to four saphenous veins in the same session.…”

Section: Non-thermal Non-tumescent Ablation Of Saphenous Veinsmentioning

confidence: 99%

Endovenous ablation of refluxing saphenous and perforating veins

Proebstle

Bos

2017

Vasa

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Summary:Since the end of the nineties endovenous thermal ablation and more recently non-thermal, non-tumescent techniques have been developed and improved. Until now, because of their favourable side effect profi le in conjunction to sustained effi cacy, in many countries they already replaced high ligation and stripping in the treatment of refl uxing saphenous veins as well as for treatment of perforators and selected tributaries. Now, studies and comparative trials are available with long-term follow-ups for most of the techniques, providing valid data on occlusion and refl ux rates, side effect profi les, and health related quality of life.

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The European multicenter cohort study on cyanoacrylate embolization of refluxing great saphenous veins

Abstract: Endovenous CA embolization of refluxing GSVs is safe and effective without the use of tumescent anesthesia or compression stockings.

Cited by 174 publications

References 21 publications

N-butyl cyanoacrylate in the treatment of venous insufficiency - the effect of embolisation with ablative polymerisation

N-butyl cyanoacrylate in the treatment of venous insufficiency - the effect of embolisation with ablative polymerisation

Endovenous Management of Varicose Veins

Endovenous ablation of refluxing saphenous and perforating veins

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