Endovenous cyanoacrylate glue to treat varicose veins and chronic venous insufficiency—Experience gained from our first 100+ truncal venous ablations in a multi-ethnic Asian population using the Medtronic VenaSeal™ Closure System

Tang, Tjun Yip; Rathnaweera, Harsha Pitumpe; Kam, Jia Wen; Chong, Tze Tec; Choke, Edward; Tan, Yih Kai

doi:10.1177/0268355519826008

Cited by 29 publications

(22 citation statements)

References 31 publications

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“…pulmonary embolism, transient ischaemic attack, nerve injury or skin necrosis. Mean operative time was approximately 41 min, which was not significantly longer than the conventional antegrade approach reported from the senior author’s group 11 ; 13/14 (92.9%) patients returned for the one-week post-operative follow-up in clinic. One patient did not return for follow-up and was contacted by telephone to review his symptoms and possible complications.…”

Section: Resultsmentioning

confidence: 62%

Retrograde technique for great saphenous vein ablation using the VenaSeal™ closure system – Ideal approach for deep seated or small below the knee refluxing truncal veins

et al. 2019

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Objectives The VenaSeal™ closure system (Medtronic, Galway, Ireland) is a novel non-thermal, non-tumescent ablative device that induces endovenous closure by inducing fibrosis of the truncal superficial vein. The conventional IFU antegrade technique is straightforward except when the great saphenous vein is small at the planned access site below the knee, deep, or steeply traverses the fascia making passage of the introducer wire to the groin difficult. We describe our technique for retrograde great saphenous vein puncture, which mitigated these access problems and assessed the effectiveness and outcomes. Methods Fourteen patients (14 legs; 14 great saphenous vein) underwent VenaSeal™ ablation via a retrograde puncture, all for great saphenous vein incompetence; 10/14 (71.4%) had C4–C5 disease. Retrograde puncture introduces the VenaSeal™ catheter in a cranial-caudal manner, with the designated puncture site at the most proximal point of the great saphenous vein reflux. Patients were reviewed at 1 week, 3, 6 and 12-months post-procedure. Post-operative outcomes and complications were recorded, along with patient satisfaction. Results The most common reason for a retrograde puncture approach was the small great saphenous vein calibre below the knee, in 9/14 (64.3%) patients. There was 100% technical success, with no major complications from the procedure; 11/14 (78.6%) patients tolerated the procedure under local anaesthesia without any sedation. There was 100% Duplex-occlusion rate at 1 week, 3, 6 and 12-months post-procedure. Conclusion The retrograde puncture technique for the VenaSeal™ Closure system is safe and effective in ablating the great saphenous vein in patients who are not amendable to the conventional antegrade puncture approach. Patients tolerated this procedure without additional mean operative time and minimal complications. More extensive studies with longer follow-up periods are required to validate the long-term outcomes of this technique.

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Section: Resultsmentioning

confidence: 62%

Retrograde technique for great saphenous vein ablation using the VenaSeal™ closure system – Ideal approach for deep seated or small below the knee refluxing truncal veins

et al. 2019

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“…Patients should be asked about cyanoacrylate allergy preoperatively to minimize risks. 45 This systematic review has some limitations. The comprehensive literature search and data extraction were performed by one author.…”

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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“…The treatment recommendations for PAUS are poorly mentioned. Since these patients are often poor candidates for conventional surgery due to advanced age and related comorbidities-and the aortic lesions, due to their segmental nature, represent an ideal anatomical target for stenting -TEVAR is increasingly being used for this indication, with encouraging results [3][4][5][6][7][8][9][10][11].…”

Section: Discussionmentioning

confidence: 99%

An unusual phenotype of acute aortic syndrome: A case report.

Shinzato¹,

Hortegal²,

F³

et al. 2020

cardiology

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Endovenous cyanoacrylate glue to treat varicose veins and chronic venous insufficiency—Experience gained from our first 100+ truncal venous ablations in a multi-ethnic Asian population using the Medtronic VenaSeal™ Closure System

Cited by 29 publications

References 31 publications

Retrograde technique for great saphenous vein ablation using the VenaSeal™ closure system – Ideal approach for deep seated or small below the knee refluxing truncal veins

Retrograde technique for great saphenous vein ablation using the VenaSeal™ closure system – Ideal approach for deep seated or small below the knee refluxing truncal veins

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

An unusual phenotype of acute aortic syndrome: A case report.

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