The same clinical effect, with fewer complications and higher patient comfort, can be achieved with lower doses of N-butyl cyanoacrylate in endovenous ablation therapy: A prospective, randomized study

Abstract

Objectives: This study aims to investigate the therapeutic effect of N-butyl cyanoacrylate (NBCA) administration on the treatment success and patient comfort in patients with venous insufficiency. Patients and methods:Between March 2019 and June 2019, a total of 80 patients (29 males, 51 females; mean age 49.6±12.0 years; range, 25 to 81 years) diagnosed with great saphenous vein incompetence and underwent endovenous ablation with <1 mL or >1.5 mLNBCA were included in this prospective, randomized study. The patients were equally divided into two groups as Group 1 (n=40) receiving <1 mL NBCA and Group 2 (n=40) receiving >1.5 mL NBCA. The patients were invited for checks on the third day and first month post-procedurally and were evaluated in terms of potential complications. Post-procedural analgesic requirements, time to first analgesic requirement, number of 500 mg paracetamol doses used over three days among patients requiring analgesia, and pain experienced using the Visual Analog Scale after the procedure and on the third day were recorded. Results:The mean lengths of vein segments subjected to NBCA application and ablation were 33 cm in Group 1 and 34 cm in Group 2 (p=0.430). Fewer adverse events were observed in Group 1 than Group 2 (phlebitis, p=0.305; ecchymosis, p=0.396; analgesic use, p=0.013; amount of analgesic used, p<0.001; time to first analgesia requirement, p<0.001). Conclusion:Our study results suggest that the same clinical success with fewer complications (ecchymosis, phlebitis, and pain) and greater patient satisfaction can be achieved using a lower dose of NBCA in the treatment of venous insufficiency.

Efficiency of the endovenous cyanoacrylate for the treatment of varicose veins using the VenablockTM system: a 24 months follow-up study of 116 patients

“…Furthermore, Tang et al [19] reported an acellular foreign body reaction in the adventitia tissue suggesting that possible extravasation of the NBCA should be taken into consideration. In their series of VV patients, Acıpayam et al [20] demostrated that a lower than 1 mL dose of NBCA was related to a fewer complication ratio and greater patient satisfaction at the end of the first month following the procedure. Thus, studies established with various dosing regimen of NBCA are required to consider the appropriate dosing for each individual in order to lower the complication rate and obtain a greater procedure efficiency.…”