Safen ven yetmezliklerinin n-butil siyanoakrilat embolizasyonu ile tedavisi: tek merkez bulguları

Amaç: Bu çalışmanın amacı N- butil siyanoakrilat embolizasyon (CAE) ile tedavi ettiğimiz ileri dereceli safen ven yetmezliklerindeki sonuçlarımızı sunmaktır. Gereç ve Yöntem: Kliniğimizde ileri dereceli safen ven yetmezliği nedeniyle CAE ile tedavi ettiğimiz 205 hasta çalışmaya dâhil edildi. Tüm hastalar CEAP (Clinical severity, Etiology, Anatomy, Pathophysiology) sınıflandırmasına göre ameliyat öncesi değerlendirildi. Postoperatif dönemde hastaların 1, 3 ve 6. aylarda kontrolleri yapılarak, klinik ve yaşam kalitesi değerlendirildi. Operasyon sonrası ve 6. aydaki yapılan Renkli Doppler Ultrasonografi (RDUS) sonuçları karşılaştırıldı. İşlemin uygulandığı damarın total oklüzyonu operasyonun başarısı olarak tanımlandı.Bulgular: Operasyon sonrası yapılan Doppler Ultrasonografi incelemelerinde hastaların tamamında safen vende total oklüzyon saptanırken (%100) 6. ayda yapılan Doppler Ultrasonografi incelemelerinde ise 1 hastada kısmı rekanalizasyon ve minimal reflü (%0,5) tespit edildi. 28 hastada (%13) istenmeyen olay – komplikasyon gelişti. Hastalar; ağrı, yanma, yorgunluk hissi, kaşıntı gibi semptomlarda 6. ayda % 90 – 96 iyileşme olduğunu ifade ederken sadece 2 hasta (%1) kötüleşme olduğunu belirtti. Sonuç: Siyanoakrilat Embolizasyon; yüksek oklüzyon ve başarı oranları, oldukça az komplikasyon ve yüksek hasta konforu sağlaması nedeniyle safen ven yetmezliklerinin tedavisinde güvenle kullanılabileceği kanaatindeyiz.

Anahtar Kelimeler:

Safen ven, Varis, Siyanoakrilat, Endovenöz tedavi

Treatment of saphenous vein insufficiency with n-butyl cyanoacrylate embolization: one center expereince

Purpose: The aim of this study was to present our results obtained from the patients with advanced saphenous vein insufficiency and treated with N- butyl cyanoacrylate embolization (CAE). Material and Methods: In the present study, we included 205 patients admitted to our clinic with advanced saphenous vein insufficiency and treated with CAE. All patients were evaluated preoperatively according to CEAP (Clinical severity, Etiology, Anatomy, Pathophysiology) classification. The patients were rechecked and, their clinics and quality of life were assessed at 1st, 3rd, and 6th months after the surgery. Moreover, results of their color Doppler ultrasounds (CDUS) obtained right after and 6 months after the operation were compared. The presence of the total occlusion in the vein treated was considered as a successful intervention. Results: While total occlusions of the veins were detected in the examinations of the Doppler Ultrasounds obtained right after the surgery in all the patients (100%), the examinations of the Doppler Ultrasounds taken at 6th months after the surgery indicated that one of the patients developed partial recanalization and minimal reflux (0.5%). However, 28 patients possessed various extend of complications (13%). Ultimately, while 90-96% of the patients expressed improvement in their sense of pain, burning, fatigue, and itching symptoms, 2 patients (1%) expressed deterioration in such symptoms at 6th month after the surgery. Conclusion: Our present results suggest that Cyanoacrylate embolization can be used safely in the treatment of advanced saphenous vein insufficiency since it provides high occlusion rates with success, rare complications and offers better comfort to the patients.

Keywords:

Saphenous vein, varices, Cyanoacrylate, endovenous treatment,

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