Department of Cardiovascular Surgery, Kahramanmaras Sutcu Imam University Faculty of Medicine, Kahramanmaras, Turkey.
Department of Biostatistics, Kahramanmaras Sutcu Imam University Faculty of Medicine, Kahramanmaras, Turkey.
Phlebology. 2021 Jul;36(6):432-439. doi: 10.1177/0268355520964296. Epub 2020 Nov 15.
To present 18-month clinical results for internal compression therapy (ICT) applied percutaneously and as a novel method in the treatment of primary deep venous insufficiency.
Thirty patients diagnosed with isolated primary femoral vein (FV) insufficiency between October 2017 and February 2018 were included in the study. Pre-procedural femoral vein diameters and reflux durations were measured. CEAP classification and Venous Clinical Severity Score (VCSS) were recorded. Pre-procedural CEAP classifications were CEAP 4 in nine patients and CEAP 3 in 21. Quality of life assessments were carried out using a Chronic Venous Insufficiency Questionnaire (CIVIQ-2). FV diameters were then reduced, and valve coaptation was established with the percutaneous application of hyaluronic acid and cyanoacrylate injected adjacent to a valve with non coapting leaflets. Venous diameters and reflux duration were again measured immediately after the procedure. Patients were followed-up at months 1, 6, and 18, at which times all parameters were re-evaluated.
Eighteen of the 30 patients were women, and 12 were men. The mean duration of the procedure was 22.7 ± 2.9 (20-30) min. Patients' FV diameters were 12.8 (11-14.7) mm before the procedure, 9.9 (9-11.5) mm immediately after, and also 9.9 (9-11.2) mm after 1.5 years (p < 0.001). Pre-procedural reflux duration ranged between 2 and 6 (median: 3) sec, and no reflux was observed in any patient immediately or one month after the procedure (p < 0.001). At 18-month follow-up, reflux lasting only 1 sec was determined in two patients. VCSS scores were 11 (10-12) pre-procedurally and 6 (4-9) at 18 months (p < 0.001). Venous Quality of Life scores were 32 (30-36) before the procedure and 18 (14-24) at 18 months (p < 0.001).
Preliminary investigation of the injection of cyanoacrylate and hyaluronic acid around one valve in an incompetent FV can result in improved hemodynamics, CEAP, VCSS and patient QOL at 18 months, without complications.
介绍一种新的经皮腔内加压治疗（ICT）方法，用于治疗原发性深静脉功能不全，报告其 18 个月的临床结果。
2017 年 10 月至 2018 年 2 月期间，共纳入 30 例诊断为单纯股静脉（FV）功能不全的患者。测量术前股静脉直径和反流持续时间。记录临床静脉严重程度评分（VCSS）和 CEAP 分类。术前 CEAP 分类为 9 例 CEAP4 级和 21 例 CEAP3 级。采用慢性静脉功能不全问卷（CIVIQ-2）评估生活质量。然后通过向非对合瓣叶附近注射透明质酸和氰基丙烯酸酯，经皮缩小 FV 直径并建立瓣叶对合。术后立即再次测量静脉直径和反流持续时间。术后 1、6 和 18 个月进行随访，重新评估所有参数。
30 例患者中，18 例为女性，12 例为男性。手术平均时间为 22.7±2.9（20-30）分钟。患者术前 FV 直径为 12.8（11-14.7）mm，术后即刻为 9.9（9-11.5）mm，术后 1.5 年时为 9.9（9-11.2）mm（p<0.001）。术前反流持续时间为 2-6 秒（中位数：3 秒），术后即刻或 1 个月后无反流（p<0.001）。18 个月随访时，有 2 例患者反流持续 1 秒。术前 VCSS 评分为 11（10-12）分，术后 18 个月为 6（4-9）分（p<0.001）。术前静脉生活质量评分 32（30-36）分，术后 18 个月为 18（14-24）分（p<0.001）。
在功能不全的 FV 周围注射氰基丙烯酸酯和透明质酸初步研究显示，在 18 个月时可改善血液动力学、CEAP、VCSS 和患者生活质量，且无并发症。
