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一种新的经皮技术:氰基丙烯酸正丁酯粘合剂治疗大隐静脉功能不全

A new percutaneous technique: N-butyl cyanoacrylate adhesive for the treatment of giant saphenous vein insufficiency.

作者信息

Bademci Mehmet Senel, Tayfur Kaptanıderya, Ocakoglu Gökhan, Yazman Serkan, Akyüz Muhammet, Yasa Haydar

机构信息

1 233472 Ordu State Hospital , Department of Cardiovascular Surgery, Ordu, Turkey.

2 Uludag University Medical Faculty Department of Biostatistics, Bursa, Turkey.

出版信息

Vascular. 2018 Apr;26(2):194-197. doi: 10.1177/1708538117724647. Epub 2017 Sep 11.

Abstract

Background We have made a retrospective evaluation of the results of the cyanoacrylate ablation technique which has recently started to be used in the treatment of giant saphenous vein insufficiency today and in which tumescent anesthesia is not required. Methods Giant saphenous vein was treated in 50 patients between September 2015 and September 2016 by using endovenous cyanoacrylate ablation. In the procedure, tumescent anesthesia and varsity socks were not used. Control duplex ultrasound evaluation was performed in the post-procedural 1st, 6th and 12th months. Venous Clinical Severity Score and Aberdeen Varicose Vein Questionnaire scores were evaluated. Results In the 50 patients who were treated, full closure was observed in giant saphenous vein in 47 (94%) patients in the 12th month control duplex ultrasound. The mean age of the patients was 46.4 (20-70) and 30 (60%) of them were female. The median Venous Clinical Severity Score scores in the 1st, 6th and 12th months were 3, 2 and 1, respectively ( p < 0.001); the median Aberdeen Varicose Vein Questionnaire scores in the 1st, 6th and 12th months were 7, 5 and 4, respectively ( p < 0.001). In the access site, two (4%) patients developed phlebitis and one (2%) developed ecchymosis. However, deep venous thrombosis, pulmonary embolism and paresthesia were not observed. Conclusion Considering the early period results in the treatment of giant saphenous vein insufficiency, cyanoacrylate ablation makes a more reliable alternative than endovenous thermal ablation methods in that it does not require tumescent anesthesia and it has a low incidence of adverse effects.

摘要

背景 我们对氰基丙烯酸酯消融技术的结果进行了回顾性评估,该技术最近开始用于治疗大隐静脉功能不全,且无需肿胀麻醉。方法 2015年9月至2016年9月期间,对50例患者采用静脉内氰基丙烯酸酯消融术治疗大隐静脉。在该手术中,未使用肿胀麻醉和弹力袜。术后第1、6和12个月进行对照双功超声评估。评估静脉临床严重程度评分和阿伯丁静脉曲张问卷评分。结果 在接受治疗的50例患者中,术后12个月对照双功超声检查发现47例(94%)患者的大隐静脉完全闭合。患者的平均年龄为46.4岁(20 - 70岁),其中30例(60%)为女性。第1、6和12个月的静脉临床严重程度评分中位数分别为3、2和1(p < 0.001);第1、6和12个月的阿伯丁静脉曲张问卷评分中位数分别为7、5和4(p < 0.001)。在穿刺部位,2例(4%)患者发生静脉炎,1例(2%)出现瘀斑。然而,未观察到深静脉血栓形成、肺栓塞和感觉异常。结论 考虑到大隐静脉功能不全治疗的早期结果,氰基丙烯酸酯消融术是一种比静脉内热消融方法更可靠的选择,因为它不需要肿胀麻醉且不良反应发生率低。

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