Novotný Karel, Roček Míla, Pádr Radek, Pavlík Radim, Polovinčák Michal, Adla Theodor, Zimolová Petra, Choi-Širůčková Jana, Weis Martin, Jirát Simon, Rohn Vilém
1 Department of Cardiology, 2nd Faculty of Medicine, Charles University, Prague and Motol University Hospital, Prague, Czech Republic.
2 Department of Radiology, 2nd Faculty of Medicine, Charles University, Prague and Motol University Hospital, Prague, Czech Republic.
Vasa. 2018 Aug;47(5):416-424. doi: 10.1024/0301-1526/a000716. Epub 2018 Jun 12.
Treating great and small saphenous vein trunk insufficiency with cyanoacrylate glue is the least taxing treatment method of all available techniques. Due to long-term unavailability of commercial kits with n-butyl-2-cyanoacrylate (histoacryl) in the Czech Republic, we used a modified technique.
Fifty-six limbs in 49 patients suffering from great saphenous vein or small saphenous vein insufficiency in combination with symptomatic chronic venous insufficiency and complicating comorbidities were treated with a modified endovascular cyanoacrylate glue application technique.
The immediate success rate of the treatment was 98 %. In follow-up intervals of six weeks, six months, one year, and two years, the anatomical success rates of embolization (recanalization of no more than 5 cm of the junction) were 98, 96, 94, and 94 %, respectively. At identical intervals the venous insufficiency was scored according to the Aberdeen Varicose Vein Questionnaire and the American Venous Clinical Severity Score. In both cases, improvement was demonstrated over the two-year follow-up, with a 0.5 % significance level. Specific clinical signs of venous insufficiency were also evaluated, such as pain, oedema, clearance of varicose veins, and healing of venous ulceration. One severe complication - a pulmonary embolism - was reported, without consequences.
We demonstrated that treating insufficient saphenous veins with modified histoacryl application brought a relief from symptoms of venous insufficiency and that the efficiency of this technique is comparable to commonly used methods.
用氰基丙烯酸酯胶治疗大隐静脉和小隐静脉主干功能不全是所有现有技术中创伤最小的治疗方法。由于在捷克共和国长期无法获得含正丁基-2-氰基丙烯酸酯（组织黏合剂）的商用套件，我们采用了一种改良技术。
对49例患有大隐静脉或小隐静脉功能不全合并症状性慢性静脉功能不全及并发合并症的患者的56条肢体，采用改良的血管内氰基丙烯酸酯胶应用技术进行治疗。
治疗的即刻成功率为98%。在六周、六个月、一年和两年的随访间隔中，栓塞的解剖成功率（吻合处再通不超过5厘米）分别为98%、96%、94%和94%。在相同间隔时间，根据阿伯丁静脉曲张问卷和美国静脉临床严重程度评分对静脉功能不全进行评分。在这两种情况下，在两年的随访中均显示有改善，显著性水平为0.5%。还评估了静脉功能不全的特定临床体征，如疼痛、水肿、静脉曲张清除情况以及静脉溃疡愈合情况。报告了1例严重并发症——肺栓塞，但无不良后果。
我们证明，用改良的组织黏合剂治疗隐静脉功能不全可缓解静脉功能不全症状，且该技术的疗效与常用方法相当。
