Bellam Premnath Krishna Prasad, Joy Binu, Raghavendra Vijayakumar Akondi, Toms Ajith, Sleeba Teena
Department of Radiology, Rajagiri Hospital, Aluva, Kerala, India.
Phlebology. 2018 Sep;33(8):547-557. doi: 10.1177/0268355517733339. Epub 2017 Sep 28.
Various treatment methods are available for the treatment of varicose veins, and there has been a recent surge in the usage of cyanoacrylate glue for treating varicose veins. Purpose To investigate the technical possibility, efficiency and safety of cyanoacrylate adhesive embolization and sclerotherapy using commonly available n-butyl cyanoacrylate glue for the treatment of primary varicose veins due to great saphenous vein reflux with or without incompetent perforators. Materials and Methods One hundred forty-five limbs of 124 patients with varicose veins due to great saphenous vein reflux were subjected to cyanoacrylate adhesive embolization and sclerotherapy - adhesive embolization of great saphenous vein in the thigh and perforators using cyanoacrylate followed by sclerotherapy of any residual varicose veins in the leg. Procedural success, venous closure rates and clinical improvement were assessed. Follow-up for 1, 3, 6, 9 and 12 months was obtained. Results Technical success rate was 100%. Saphenous vein closure rate was 96.5% at one year. There was no femoral venous extension of cyanoacrylate in any of the patients. Posterior tibial vein extension of cyanoacrylate was seen in three patients (2.6%) without untoward clinical effect.Significant improvement was found in venous clinical severity score (VCSS) from a baseline mean of 7.98 ± 4.42 to 4.74 ± 3, 1.36 ± 1.65 and 0.79 ± 1.19 at 1, 6 and 12 months' follow-up. Ulcer healing rate was 100%. Conclusion Cyanoacrylate adhesive embolization and sclerotherapy for the treatment of primary varicose veins is efficacious and can be performed as an outpatient procedure, but has a guarded safety profile due to its propensity to cause deep venous occlusion if not handled carefully.
治疗静脉曲张有多种治疗方法，最近氰基丙烯酸酯胶水在治疗静脉曲张中的使用激增。目的 探讨使用市售正丁基氰基丙烯酸酯胶水进行氰基丙烯酸酯粘合剂栓塞和硬化疗法治疗大隐静脉反流伴或不伴有功能不全穿通支引起的原发性静脉曲张的技术可行性、有效性和安全性。材料与方法 对124例因大隐静脉反流导致静脉曲张的患者的145条肢体进行氰基丙烯酸酯粘合剂栓塞和硬化疗法——使用氰基丙烯酸酯对大腿和穿通支的大隐静脉进行粘合剂栓塞，随后对腿部任何残留的静脉曲张进行硬化疗法。评估手术成功率、静脉闭合率和临床改善情况。获得了1、3、6、9和12个月的随访结果。结果 技术成功率为100%。一年时大隐静脉闭合率为96.5%。所有患者均未出现氰基丙烯酸酯向股静脉延伸的情况。3例患者（2.6%）出现氰基丙烯酸酯向胫后静脉延伸，但无不良临床效果。在1、6和12个月的随访中，静脉临床严重程度评分（VCSS）从基线平均值7.98±4.42显著改善至4.74±3、1.36±1.65和0.79±1.19。溃疡愈合率为100%。结论 氰基丙烯酸酯粘合剂栓塞和硬化疗法治疗原发性静脉曲张是有效的，可作为门诊手术进行，但由于如果操作不当有导致深静脉闭塞的倾向，其安全性有待谨慎评估。
