Nonthermal, Nontumescent Endovenous Treatment of Varicose Veins

Tekın, Ali; Tuncer, Osman Nuri; Memetoğlu, Mehmet Erdem; Arslan, Ümit; Öztekin, Ahmet; Yağmur, Bayram; Biçer, Mahmut; Özmen, Rıfat

doi:10.1016/j.avsg.2016.03.005

Cited by 43 publications

(47 citation statements)

References 19 publications

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“…This shows that CAGE, with the Venaseal TM Closure System, when administered in primary care by an experienced GP, has high levels of efficacy similar to the current literature. 10,13,15,16,24,25 It also shows that incomplete closures can be countered using ultrasound-guided foam sclerotherapy, raising the efficacy of Venaseal TM with adjuvant foam sclerotherapy to 100%.…”

Section: Discussionmentioning

confidence: 98%

“…CA glue was introduced by standard regime with manual compression and starting 5 cm below the sapheno-femoral junctions. 10 Due to tortuosity of the treated veins, two entry sites were required on each leg. In total for both veins, 4.5 mL of CA glue was used.…”

Section: Case Studymentioning

confidence: 99%

“…The Venaseal TM Closure System (Medtronic Inc., Minneapolis, MN, USA) was approved by the United States Food and Drug Administration in February 2015 and was introduced into New Zealand in October 2015. Other cyanoacrylate glue embolization (CAGE) systems are available such as Biolas VariClose Ò (FG Group, Ankara, Turkey), 10 but they do not yet have enough published evidence to support their routine use. CAGE is available in New Zealand, in the form of the Venaseal TM Closure System, as shown in Figure 1.…”

Section: Introductionmentioning

confidence: 99%

“…We wished to establish whether our CAGE procedures have similar efficacy and adverse events rates as are reported in the literature. [9][10][11][12][13]15,16 Methods Data were collected from 0800 Vein Dr, a primary care vein clinic with branches in Hastings, Palmerston North and Auckland. We retrospectively reviewed the clinical records of 107 consecutive patients who underwent CAGE with the Venaseal TM Closure System between 11 November 2015 and 12 December 2017.…”

Section: Introductionmentioning

confidence: 99%

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Audit of the efficacy and complications of cyanoacrylate glue embolisation to treat varicose veins in primary care

Weaver¹,

Weaver²

2019

J Prim Health Care

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INTRODUCTIONCyanoacrylate glue embolization (CAGE) is a non-surgical procedure that uses a proprietary medical adhesive, delivered endovenously to close truncal, varicose veins. AIMTo describe CAGE administered by a New Zealand general practitioner (GP) in primary care. METHODSThe procedures were performed by a single GP with a special interest and 19 years’ clinical experience in procedural phlebology. The clinical records of 107 consecutive patients who underwent CAGE over a 2-year period were retrospectively reviewed. Some patients had bilateral disease and some had more than one truncal vein per leg treated. Data on 173 truncal veins were included in the audit. Clinical data, procedural details and postprocedural course were recorded and analysed for 71 females and 36 males. RESULTSIn total, 173 truncal veins were treated. They included the anterior accessory saphenous vein, the great saphenous vein, the small (lesser) saphenous vein and the thigh extension with a range of clinical severity. The most commonly treated truncal vein was the great saphenous vein with an average truncal diameter of 8.8mm (2.9s.d.). Of the 173 treated truncal veins, two failed to seal with CAGE, but were sealed after adjuvant ultrasound-guided foam sclerotherapy treatment. Post CAGE, 14.5% of treated truncal veins developed a phlebitis. DISCUSSIONThis audit shows that varicose veins can be treated in general practice with high levels of anatomic efficacy and few adverse effects.

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Section: Discussionmentioning

confidence: 98%

Section: Case Studymentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Audit of the efficacy and complications of cyanoacrylate glue embolisation to treat varicose veins in primary care

Weaver¹,

Weaver²

2019

J Prim Health Care

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“…105,106 Initial results are encouraging, but additional studies are needed to further evaluate the benefits of these new techniques versus thermal ablation and surgery.…”

Section: Management Of Vvsmentioning

confidence: 99%

Matrix Metalloproteinases in Remodeling of Lower Extremity Veins and Chronic Venous Disease

Chen

Peng

Raffetto

et al. 2017

Progress in Molecular Biology and Translational Science

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The veins of the lower extremity are equipped with efficient wall, contractile venous smooth muscle (VSM) and competent valves in order to withstand the high venous hydrostatic pressure in the lower limb and allow unidirectional movement of deoxygenated blood towards the heart. The vein wall structure and function are in part regulated by matrix metalloproteinases (MMPs). MMPs are zinc-dependent endopeptidases that are secreted as inactive proMMPs by different cells in the venous wall including fibroblasts, VSM and leukocytes. ProMMPs are activated by other MMPs, proteinases, and other endogenous and exogenous activators. MMPs degrades various extracellular matrix (ECM) proteins including collagen and elastin, and could affect other cellular processes including endothelium-mediated dilation, VSM cell migration and proliferation as well as modulation of Ca2+ signaling and contraction in VSM. It is thought that increased lower limb venous hydrostatic pressure increases hypoxia inducible factors and other MMP inducers such as EMMPRIN, leading to increased MMP expression/activity, ECM protein degradation, vein wall relaxation, and venous dilation. Vein wall inflammation and leukocyte infiltration cause additional increases in MMPs, and further vein wall dilation and valve degradation, that could lead to chronic venous disease and varicose veins (VVs). VVs are often presented as vein wall dilation and tortuosity, incompetent venous valves and venous reflux. Different regions of VVs show different MMP levels and ECM proteins with atrophic regions showing high MMP levels/activity and little ECM compared to hypertrophic regions with little or inactive MMPs and abundant ECM. Treatment of VVs includes compression stockings, venotonics, sclerotherapy or surgical removal. However, these approaches do not treat the cause of VVs, and other lines of treatment may be needed. Modulation of endogenous tissue inhibitors of metalloproteinases (TIMPs), and exogenous synthetic MMP inhibitors may provide new approaches in the management of VVs.

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Catheter‐Based Therapy for Varicose Veins

Terre

Chavarria

2023

Endovascular Interventions

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Nonthermal, Nontumescent Endovenous Treatment of Varicose Veins

Cited by 43 publications

References 19 publications

Audit of the efficacy and complications of cyanoacrylate glue embolisation to treat varicose veins in primary care

Audit of the efficacy and complications of cyanoacrylate glue embolisation to treat varicose veins in primary care

Matrix Metalloproteinases in Remodeling of Lower Extremity Veins and Chronic Venous Disease

Catheter‐Based Therapy for Varicose Veins

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