Barranco-Trabi Javier J, Desai Kaushal, Chen Daniel, Kellicut Dwight, Brandon Wiberg, Chi Sharon, Copeland Nathanial K, Kamau Edwin, Ngauy Viseth
Department of Medicine, Tripler Army Medical Center and U.S. Department of Veterans Affairs, Honolulu, HI.
Division of Vascular Surgery, Department of Surgery, Tripler Army Medical Center, Honolulu, HI.
J Vasc Surg Cases Innov Tech. 2024 Feb 13;10(6):101454. doi: 10.1016/j.jvscit.2024.101454. eCollection 2024 Dec.
Chronic venous disease is a common condition causing pain, discomfort, and skin changes that effect quality of life and productivity. Various treatment modalities have been developed to manage retrograde venous blood flow and its associated complications, ranging from conservative therapy to more invasive techniques such as endothermal ablation and cyanoacrylate closure (CAC). Recently, CAC has gained popularity due to its faster recovery time and lower incidence of postprocedure discomfort and complications. The most commonly reported side effects include phlebitis, access site bruising or pain, and dermatitis. We present a case of phlebitis caused by following a CAC procedure using the VenaSeal device (Medtronic) in a patient with diabetes. The patient required surgical resection of the affected vein and prolonged antibiotic therapy. Bacterial contamination of the cyanoacrylate adhesive within a vein poses a significant treatment challenge with antibiotics alone due to biofilm production. Aggressive source control with removal of the adhesive-treated vein could be required for treatment of endovascular infections resulting from these common procedures.
慢性静脉疾病是一种常见病症，会导致疼痛、不适和皮肤变化，影响生活质量和工作效率。为了处理静脉血液逆流及其相关并发症，人们开发了各种治疗方式，从保守治疗到诸如腔内热消融和氰基丙烯酸酯封闭术（CAC）等更具侵入性的技术。最近，由于恢复时间更快且术后不适和并发症发生率更低，CAC受到了欢迎。最常报告的副作用包括静脉炎、穿刺部位瘀伤或疼痛以及皮炎。我们报告一例糖尿病患者在使用VenaSeal装置（美敦力公司）进行CAC手术后发生静脉炎的病例。该患者需要对受影响的静脉进行手术切除并延长抗生素治疗。由于生物膜的产生，静脉内氰基丙烯酸酯粘合剂的细菌污染仅用抗生素治疗会带来重大挑战。对于这些常见手术导致的血管内感染，可能需要积极的源头控制，即切除经粘合剂处理的静脉。
