Kamikawa Yuki, Kinoshita Takeshi, Saito Yosuke, Oyama Tetsuma, Tabata Minoru, Inaba Hirotaka
Department of Cardiovascular Surgery, Juntendo University Hospital, Tokyo, Japan.
Department of Cardiovascular Surgery, Toda Chuo General Hospital, Saitama, Japan.
Int J Vasc Med. 2025 May 29;2025:9668464. doi: 10.1155/ijvm/9668464. eCollection 2025.
Varicose veins are a common condition affecting millions worldwide. Cyanoacrylate closure (CAC) and radiofrequency ablation (RFA) are widely used minimally invasive treatments. CAC offers advantages such as eliminating tumescent local anesthesia (TLA) and reducing nerve injury risk. However, there are few reports comparing CAC and RFA outcomes in Japan. This study is aimed at evaluating the efficacy and safety of CAC and RFA for treating great saphenous vein (GSV) and small saphenous vein (SSV) varicose veins. A retrospective, single-center study was conducted with 157 patients (178 limbs) who underwent either CAC ( = 96) or RFA ( = 82) from January 2020 to October 2023. Postoperative occlusion rates, complications, and risk factors for phlebitis were analyzed. Follow-up ultrasound examinations were conducted at up to 3 months postoperatively. Statistical analyses included -tests, Mann-Whitney tests, and multivariate logistic regression. Both CAC and RFA achieved a 100% occlusion rate at 3 months. In the CAC group, significantly longer vein segments were treated compared to those in the RFA group (46 ± 14 cm vs. 35 ± 13 cm, < 0.05). However, phlebitis occurred in 15% of the CAC group, whereas none were reported in the RFA group ( < 0.05). Multivariate analysis identified preoperative swelling (OR: 5.60, 95% CI: 1.33-23.6, < 0.05) and treated vein length as independent risk factors for phlebitis. All phlebitis cases resolved with conservative treatment. One patient in the RFA group experienced transient paresthesia. CAC is a viable alternative to RFA, demonstrated equivalent occlusion rates, though CAC exhibited a higher incidence of phlebitis. Careful patient selection and perioperative management may help mitigate risks. Further studies with larger cohorts and longer follow-up are needed to optimize treatment protocols and long-term outcomes.
静脉曲张是一种常见病症，全球数以百万计的人受其影响。氰基丙烯酸酯闭合术（CAC）和射频消融术（RFA）是广泛应用的微创治疗方法。CAC具有消除肿胀局部麻醉（TLA）和降低神经损伤风险等优势。然而，在日本，比较CAC和RFA治疗效果的报告较少。本研究旨在评估CAC和RFA治疗大隐静脉（GSV）和小隐静脉（SSV）静脉曲张的疗效和安全性。对2020年1月至2023年10月期间接受CAC（n = 96）或RFA（n = 82）治疗的157例患者（178条肢体）进行了一项回顾性单中心研究。分析了术后闭塞率、并发症以及静脉炎的危险因素。术后最多3个月进行随访超声检查。统计分析包括t检验、曼-惠特尼U检验和多变量逻辑回归。CAC和RFA在3个月时的闭塞率均达到100%。与RFA组相比，CAC组治疗的静脉段明显更长（46±14厘米 vs. 35±13厘米，P < 0.05）。然而，CAC组有15%发生了静脉炎，而RFA组未报告有静脉炎发生（P < 0.05）。多变量分析确定术前肿胀（OR：5.60，95%CI：1.33 - 23.6，P < 0.05）和治疗的静脉长度是静脉炎的独立危险因素。所有静脉炎病例经保守治疗后均痊愈。RFA组有一名患者出现短暂性感觉异常。CAC是RFA的一种可行替代方法，显示出相当的闭塞率，尽管CAC的静脉炎发生率较高。仔细选择患者和进行围手术期管理可能有助于降低风险。需要进行更大样本量和更长随访时间的进一步研究，以优化治疗方案和长期治疗效果。
