Kronik Venöz yetmezlikte Venaseal Sistemi kullanılarak yapılan endovenöz siyanoakrilat ile kapatma tedavisinin sonuçları

Amaç: Safen venlerin endovenöz siyanoakrilat ile kapatılması, termal ve sklerozan olmayan ve tatmin edici sonuçlara sahip bir ablasyon tekniğidir. Bu çalışmanın amacı, Venaseal kapatma sisteminin kronik venöz yetmezlikteki etkinliğini göstermektir. Yöntem: Mart 2014 - Mart 2019 tarihleri arasında hastanemizde 27 hastaya semptomatik safen ven reflüsü için VenaSeal kapatma sistemi ile toplam 40 işlem uygulandı. Yapıştırıcı ablasyon işlemlerinin yanı sıra 16 hastaya eş zamanlı mini flebektomi, 3 hastaya perforan ven ligasyonu ve 1 hastaya ön aksesuar safen ven ligasyonu yapıldı. Hastaların yaş ortalaması 44,4 ± 13,8 (19-67) idi. Tedaviden 1 ve 12 ay sonra hedef damara Doppler ultrasonografi yapıldı. Tümesan anestezi ve kompresyon çorapları kullanılmadı. Bulgular: Ortalama takip süresi 34.3 ± 17 aydı. Anatomik başarı oranı 1 ayda % 100, 1 yılda % 100 idi ve tedavi edilen ven segmentinde rekanalizasyon görülmedi. Tüm prosedürler, 10 puanlık bir ölçekte, medyan görsel analog skala (VAS) ağrı skoru 3.0 (aralık: 2-5) ile iyi tolere edildi. Ortalama preoperatif revize venöz klinik şiddet skoru (VCSS) 7.5 ± 2.6 idi ve bir aylık takipte 2.6 ± 0.7’ye düştü (p

Outcomes of Endovenous Cyanoacrylate Closure Using Venaseal System for Chronic Venous Insufficiency

Purpose: Endovenous cyanoacrylate closure of saphenous veins is a nonthermal, nonsclerosant ablation technique with satisfactory results. The objective of this study is to indicate the impact of Venaseal closure system in chronic venous insufficiency. Methods: Between March 2014- March 2019, 27 patients underwent a total of 40 procedures with the VenaSeal closure system for symptomatic saphenous vein reflux in our hospital. Beside glue ablation procedures, 16 patients underwent concomitant mini phlebectomy, 3 patients underwent perforan vein ligation and 1 patient underwent anterior accessory saphenous vein ligation. The mean age of the patients were 44.4±13.8 (19-67). Doppler ultrasound of the target vein was performed one and 12 months after treatment. Tumescent anesthesia and compression stockings were not used. Results: Mean follow up time was 34.3 ±17 months. The anatomical success rate was 100% at 1 month and 100% at 1 year and there was no recanalization in treated vein segment. All procedures were well tolerated with a median visual analog scale (VAS) pain score of 3.0 (range: 2–5) on a 10-point scale. The mean pre-operative revised venous clinical severity score was 7.5±2.6, which improved to 2.6±0.7, p< 0.001 at one month follow-up. Deep vein thrombosis and pulmonary thromboembolism were not detected. Phlebitis was seen in 2 (7,4%) patients and hypersensitivity reaction occured in one patient (3,7%). Conclusion: Endovenous cyanoacrylate closure of refluxing saphenous veins offers a safe and effective treatment with reduced side effects.Keywords: Cyanoacrylate; saphenous vein; tumescent anesthesia; venous insufficiency

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