Department of Radiology, Konkuk University Medical Center, Konkuk University School of Medicine, Seoul, Republic of Korea.
Department of Radiology, Konkuk University Medical Center, Konkuk University School of Medicine, Seoul, Republic of Korea.
J Vasc Surg Venous Lymphat Disord. 2019 May;7(3):375-381. doi: 10.1016/j.jvsv.2018.10.016. Epub 2019 Jan 3.
The objective of this study was to evaluate the effectiveness and safety of endovenous cyanoacrylate closure (CAC) of incompetent great saphenous vein (GSV) and to assess the regression of varicose vein following CAC without a concomitant procedure.
A total of 63 limbs in 48 patients treated with CAC because of an incompetent GSV between December 2016 and November 2017 were retrospectively evaluated. In five limbs, incompetent GSV and small saphenous vein were treated simultaneously in the same session. Duplex ultrasound, Venous Clinical Severity Score, degree of regression of varicose veins, and adverse events were examined at intervals of 1 week, 1 month, 3 months, 6 months, and 12 months.
In 63 limbs, of which 60 were available for follow-up, all treated GSVs showed complete closure during the follow-up period (8.4 ± 3.0 months). Venous Clinical Severity Scores at the time of all follow-up visits were significantly lower (P < .001) than those before CAC. Complete resolution of varicose veins was noted in 38 limbs (71.7%) after 3-month follow-up. The proportion of limbs showing >50% varicose vein regression reached 90.6%. The more that varicosity entry was covered (P = .002) and the farther down the leg the access site was located (P = .024), the more complete resolution of varicose veins was observed. Phlebitis occurred in 10 limbs (16.7%), and hyperpigmentation occurred in 8 limbs (13.3%).
CAC is safe and effective for the treatment of an incompetent GSV. It also shows a satisfactory result with the regression of varicose veins. Covering the entry of varicosities and accessing lower down the leg are associated with more complete resolution of varicose veins.
本研究旨在评估静脉内氰基丙烯酸酯封闭（CAC）治疗功能不全大隐静脉（GSV）的有效性和安全性，并评估 CAC 后不伴伴随手术的静脉曲张消退情况。
回顾性分析 2016 年 12 月至 2017 年 11 月因功能不全 GSV 接受 CAC 治疗的 48 例患者的 63 条肢体。5 条肢体在同一次治疗中同时处理功能不全 GSV 和小隐静脉。每隔 1 周、1 个月、3 个月、6 个月和 12 个月，使用双功能超声、静脉临床严重程度评分、静脉曲张消退程度和不良事件进行检查。
63 条肢体中，60 条肢体可进行随访，所有治疗的 GSV 在随访期间均完全闭塞（8.4±3.0 个月）。所有随访时的静脉临床严重程度评分均明显低于 CAC 前（P<0.001）。3 个月随访后，38 条肢体（71.7%）静脉曲张完全消退。静脉曲张消退>50%的肢体比例达到 90.6%。静脉瘤入口覆盖越多（P=0.002），入路位置越低（P=0.024），静脉曲张消退越完全。10 条肢体（16.7%）发生静脉炎，8 条肢体（13.3%）发生色素沉着。
CAC 治疗功能不全 GSV 安全有效，静脉曲张消退效果满意。静脉瘤入口覆盖和入路位置越低，静脉曲张消退越完全。
