Cyanoacrylate closure for peripheral veins: Consensus document of the Australasian College of Phlebology

Abstract

Background

NTNT Methods – Efficacy and Safety Issue

“…In case of patients with systemic autoimmune disorders, Australasian College of Phlebology recommend EVTA instead of CAC, which should be offered only if no other safe treatment options are available, and with pre and post treatment steroid administration. [2] Phlebitic reaction has been reported by Proebstle et al in 11.4 % with a median duration of 6.5 days. [9] In the Waves study phlebitis in the treatment area or in tributaries occurred in 20 % of patients but completely resolved in all but one, in a month.…”

“…There is no evidence-based data regarding the maximum dose of CA per treatment session. Australasian College of Phlebology recommends an upper limit of 10 ml [2].…”

“…[4,6] The great advantage of CAC is that there is no need for compression therapy after the procedure. [2][3][4][5][6][7][8][9][10][11][12][13][14] Adverse events Adverse events were reported in all studies of CAC, although their type and rate varied. [3][4][5][6][7][8][9][10] The most common reported adverse event was a local inflammatory reaction of the skin and subcutaneous area overlying the treated vein, reported at a rate of 11.4 % in the study by Almeida et al and 20 % in a study by Morrison et al [3,8] Usually it's not specified if it is a truth phlebitis or an immune skin reaction resembling phlebitis, related to a local hypersensitivity reaction to the CA implantation.…”

“…There have been no clinical reports of anaphylactic reactions and only a few reports concerning allergic reactions have been published. [2] According to systematic review a rate of hypersensitivity reaction to the CA is 7 %. [10] Gibson et al reported the appearance of hypersensitivity in 6 % of patients.…”

“…It commonly remains asymptomatic, but may progress to suppuration, necrosis and ulceration. [2] Despite the large number of cases performed worldwide, only a few late granulomatous reactions have been reported, some of them with considerable morbidity. [15] Immediate and delayed hypersensitivity reaction with granulomas formation have been reported to be the most significant concerns of clinicians.…”