Venöz kapak yetmezliği için N-butil siyanoakrilatın girişimsel enjeksiyonunu kullanan yeni bir harici valvüloplasti uygulaması

Amaç: Kronik venöz yetmezlik (CVI), venöz kapaklar yeterince çalışmadığında ortaya çıkan yaygın bir hastalıktır. Bu nedenle tedavi stratejileri, kapakların fonksiyonlarının iyileştirilmesine dayanır. Bu çalışmada, venöz kapak fonksiyonlarını iyileştirmek için N-Butil Siyanoakrilat'ın harici uygulamasını değerlendirmeyi amaçladık. Yöntemler: Ocak 2020-Haziran 2020 tarihleri arasında kardiyovasküler cerrahi kliniğine CVI şikayetleri ile başvuran hastalar geriye dönük olarak kayıt altına alındı. Ekstravenöz N-Butil Siyanoakrilat uygulaması yapılan 30 hasta (fonksiyonu bozulmuş venöz kapak çevresini sarma olarak ekstravenöz uygulama) çalışmaya dahil edildi. Preoperatif ve postoperatif (3. ve 6. ay) venöz Doppler ultrason bulguları ve şikayetleri not edildi ve sonuçlar karşılaştırıldı. Bulgular: Büyük safen ven çapı postoperatif dönemde geriledi (9,27 (1,95 mm) ve. 6,27 (2,16), P=0,001). Preoperatif verilerle karşılaştırıldığında, postoperatif ultrason değerlendirmelerinde azalan safenofemoral reflü süreleri saptandı (0,77 (0,87) ve 4,77 (0,97) saniye). Operasyondan aylar sonra ödem, pigmentasyon, bacakta huzursuzluk vb. şikayetler geriledi. Sonuç: Sonuçlarımız, N-Butil Siyanoakrilat jelin harici uygulamasının orta vadede venöz kapak fonksiyonlarının iyileştirilmesinde etkili olduğunu gösterdi.

Anahtar Kelimeler:

Kronik venöz yetmezlik, venöz kapak yetersizliği, tedavi, harici jel uygulaması

A new application of external valvuloplasty using interventional injection of N-butyl cyanoacrylate for malfunctioning venous valves

Aim: Chronic venous insufficiency (CVI) is a common disorder that occurs when the venous valves are not working sufficiently. The treatment strategies depend on ameliorating the function of the valves. The aim of this study was to evaluate the external application of N-Butyl Cyanoacrylate to improve venous valves’ functions. Methods: Thirty patients with CVI who were admitted to the cardiovascular surgery clinic with CVI complaints and underwent extravenous N-Butyl Cyanoacrylate application (extravenous application to the area surrounding the malfunctioning venous valves) between January 2020 and June 2020 were included in this retrospective cohort study. Preoperative and postoperative (third and sixth month) venous Doppler ultrasound findings and complaints were noted, and the results were compared. Results: The diameter of the great saphenous vein was found to have decreased during the postoperative period (9.27 (1.95 mm) vs. 6.27 (2.16), P=0.001). Decremental saphenofemoral reflux durations were detected in postoperative ultrasound evaluations when compared with preoperative data (0.77(0.87) vs. 4.77(0.97) seconds). CVI complaints, including oedema, pigmentation and restless leg syndrome, improved within months after the operation. Conclusion: The external application of N-Butyl Cyanoacrylate gel seems effective for recovering venous valve function in the medium term.

Keywords:

Chronic venous insufficiency, incompetent venous valve, treatment, external gel application,

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