Varisli Damarlarda Siyanoakrilat Tutkal ve Endovenöz Lazer Ablasyonunun Karşılaştırmalı Çalışması

Amaç: Bu çalışmanın amacı, varis tedavisi için iki minimal invaziv teknik olan siyanoakrilat yapıştırıcı (CG) ve endovenöz lazer ablasyon (EVLA) arasında bir karşılaştırma sağlamaktır. Gereç ve Yöntem: Bu çalışma, Ocak 2018 ile Aralık 2021 arasında EVLA veya CG teknikleri uygulanan varisli hastaların dahil edildiği bir retrospektif çalışma idi. Hastaların demografik özellikleri, hasta şikayet ve semptomları, postoperatif 1. ve 6. ay doppler-ultrason kontrol sonuçları ve preoperatif-postoperatif karşılaştırmalar yapıldı. Bulgular: Toplam 200 yetişkin hasta CG (n=54) veya EVLA (n=146) teknikleri ile tedavi edildi. 1. ve 6. aylarda yapılan doppler ultrason testlerinde EVLA ve CG gruplarının başarı oranları sırasıyla %96,6 ve %92,6 olarak belirlendi. Sonuç: CG ve EVLA hastalarının ameliyat öncesi Venöz Klinik Şiddet Skoru sonuçları değerlendirildiğinde her iki grupta da istatistiksel olarak anlamlı iyileşmeler gözlendi. Veri analizinden CG grubunda işlem süresinin anlamlı olarak daha kısa olduğunu, CG grubunda ekimoz ve eritem belirgin olarak daha az görüldüğünü ve CG grubunda normal aktiviteye dönüş süresinin daha kısa olduğunu saptadık.

Anahtar Kelimeler:

Lazer ablasyon, minimal invaziv cerrahi prosedürler, varisli damarlar, siyanoakrilat yapıştırıcı

Comparative Study of Cyanoacrylate Glue and Endovenous Laser Ablation Techniques for the Treatment of Varicose Veins

Aim: The aim of this study is to provide a comparison between two minimally invasive techniques; cyanoacrylate glue (CG) and endovenous laser ablation (EVLA) for the treatment of varicose veins. Material and Method: This study was a retrospective study of patients with varicose veins who underwent EVLA or CG techniques between January 2018 and December 2021. The demographic characteristics of the patients, patient complaints and symptoms, postoperative 1st and 6th month Doppler-Ultrasound control results and preoperative-postoperative comparisons were made. Results: A total of 200 adult patients were treated with CG (n=54) or EVLA (n=146) techniques. The doppler- ultrasound tests of the 1st and 6th months determined that the success rates of the EVLA and CG groups were 96.6% and 92.6%, respectively. Conclusion: Statistically significant was observed in both groups when the results of the pre-postoperative Venous Clinical Severity Score of CG and EVLA patients were evaluated. From the data analysis, we have found that the duration of the procedure was significantly shorter in the CG group, the ecchymosis and erythema were observed significantly less in the CG group, and the return time to normal activity was shorter in the CG group.

Keywords:

Laser ablation, minimally invasive surgical procedures, varicose veins, cyanoacrylate glue,

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Bergan JJ: Surgical procedures for varicose veins: Axial stripping and stab avulsion. In Bergan JJ, Kistner RL (eds): Atlas of venous Surgery. Philadelphia, WB Saunders, 1992.
Luebke T, Brunkwall J. Systematic review and meta-analysis of endovenous radiofrequency obliteration, endovenous laser therapy, and foam sclerotherapy for primary varicosis. J Cardiovasc Surg 2008;49:213-33.
Brar R,and, Nordon IM, Hinchliffe RJ,et al, Thompson MM. Surgical management of varicose veins: meta-analysis. Vascular 2010;18:205-20.
Rutherford RB, Padberg Jr FT, Comerota AJ, et al. Kistner RL, Meisner MH, Moneta GL. Venous severity scoring: an adjunct to venous outcome assessment. J Vasc Surg 2000;31:1307-12.
Passman MA, McLafferty RB, Lentz MF, et al. Validation of Venous Clinical Severity Score (VCSS) with other venous severity assessment tools from the American Venous Forum, National Venous Screening Program. J Vasc Surg 2011;54:2S-9S.
Rasmussen L, Lawaetz M, Bjoern L, et al. Randomized clinical trial comparing endovenous laser ablation and stripping of the great saphenous vein with clinical and duplex outcome after 5 years. J vasc Surg 2013;58:421-6.
Koramaz İ, Kılıç HE, Gökalp F, et al. Ablation of the great saphenous vein with nontumescent n-butyl cyanoacrylate versus endovenous laser therapy. J Vasc Surg, Venous and Lymphatic Disorders 2017;5:210-5.
Wang YM, Cheng LF, Li N, et al. Histopathological study of vascular changes after intra-arterial and intravenous injection of N-butyl-2-cyanoacrylate. Chin J Dig Dis 2006;7:175-9.
Almeida JI, Javier JJ, Mackay EG, et al. Two-year follow-up of first human use of cyanoacrylate adhesive for treatment of saphenous vein incompetence. Phlebology 2015;30:397-404.
Robert F, Merchant RF, Pichot O. Closure Study Group. Long-term outcomes of endovenous radiofrequency obliteration of saphenous reflux as a treatment for superficial venous insufficiency. J Vasc Surg 2005;42:502-9.
Jin HY, Ohe HJ, Hwang JK, et al. Radiofrequency ablation of varicose veins improves venous clinical severity score despite failure of complete closure of the saphenous vein after 1 year. Asian J Surg 2017;40:48-54.
Pleister I, Evans J, Vaccaro PS, et al. Natural history of the great saphenous vein stump following endovenous laser therapy. Vasc Endovascular Surg 2008;42:348-51.
AM van Rij, GT Jones, BG Hill. Mechanical inhibition of angiogenesis at the saphenofemoral junction in the surgical treatment of varicose veins: early results of a blinded randomized controlled trial. Circulation 2008;118:66-74.
Proebstle T. Status of cyanoacrylate glue for saphenous ablation. In: Presented at the 10th International Vein Congress, Miami, Florida, USA, 31 May-3 June 2012.
Goren G, Yellin AE. Ambulatory stab evulsion phlebectomy for truncal varicose veins. Am J Surg 1991;162:166-74.
Ricci S, Georgiev M, Goldman MP, et al: AmbulatoryPhlebectomy, ed 2, Boca Raton, Fl, 2005, Taylor and Francis.[https://dokumen.tips/documents/ambulatory-phlebectomy.html]
Bozkurt AK, Yılmaz MF. A prospective comparison of a new cyanoacrylate glue and laser ablation for the treatment of venous insufficiency. Phlebology 2016;31:106-13.