Falvo Nicolas, Latreche Amine, Chevallier Olivier, Ledan Frédérik, Jandot Maud, Daoud Héla, Fréchier Léo, Loffroy Romaric
Image-Guided Therapy Center, ICMUB Laboratory, UMR CNRS 6302, Department of Vascular and Interventional Radiology, François-Mitterrand University Hospital, 14 Rue Paul Gaffarel, BP 77908, 21079 Dijon, France.
Diagnostics (Basel). 2023 Jul 8;13(14):2313. doi: 10.3390/diagnostics13142313.
Endovenous thermal methods are superseding surgical stripping for treating chronic superficial venous disease but require tumescent anesthesia and can cause heat-related nerve injuries. Endovenous cyanoacrylate ablation is a more recent technique that does not share these drawbacks. A retrospective observational study of consecutive adults managed with endovenous cyanoacrylate was conducted in 2018-2021 at a single university center. The follow-up was 18 months. We identified factors associated with target vein closure at 18 months and measured changes in quality of life using the generic 36-item Short-Form (SF-36) tool and the venous disease-specific VEINES-QOL/Sym questionnaire. Adverse events were collected. In the 55 study patients with 67 treated veins, the closure rate at 18 months was 94% (95% CI, 85-98%). Target vein diameter ≥9.5 mm had 81% sensitivity and 75% specificity for predicting recanalization. Quality-of-life scores improved significantly ( < 0.001 for both surveys). The only adverse event was a type IV allergic reaction to cyanoacrylate that was resolved with corticosteroid and histamine-antagonist therapy. Endovenous cyanoacrylate ablation was highly effective and is safe in experienced hands. Studies are warranted to determine whether changes in the protocol increase the closure rate in patients with target veins ≥9.5 mm in diameter.
腔内热消融方法正在取代手术剥脱术治疗慢性浅表静脉疾病,但需要肿胀麻醉且可能导致与热相关的神经损伤。腔内氰基丙烯酸酯消融术是一种较新的技术,不存在这些缺点。2018年至2021年在一所大学中心对连续接受腔内氰基丙烯酸酯治疗的成年人进行了一项回顾性观察研究。随访时间为18个月。我们确定了与18个月时目标静脉闭合相关的因素,并使用通用的36项简短形式(SF-36)工具和静脉疾病特异性VEINES-QOL/Sym问卷测量生活质量的变化。收集不良事件。在55例研究患者的67条治疗静脉中,18个月时的闭合率为94%(95%CI,85-98%)。目标静脉直径≥9.5mm对预测再通的敏感性为81%,特异性为75%。生活质量评分显著改善(两项调查均P<0.001)。唯一的不良事件是对氰基丙烯酸酯的IV型过敏反应,通过皮质类固醇和组胺拮抗剂治疗得以解决。腔内氰基丙烯酸酯消融术非常有效,在经验丰富的医生手中是安全的。有必要进行研究以确定方案的改变是否能提高直径≥9.5mm目标静脉患者的闭合率。