Popüler olan, artık popüler olmayabilir: Kronik venöz yetmezliğin cerrahi tedavisinde siyanoakrilat ve diğer alternatifler

Yirmi birinci yüzyılın başlangıcı ile beraber, venöz yetmezliğin cerrahi tedavisinde endovenöz lazer ablasyon ve radyofrekans ablasyon yöntemlerini içeren büyük gelişmeler yaşandı. Bu yöntemler, klavuzlarda da önerilen birinci seçenek terapi alternatifleri haline geldi. Tatmin edici sonuçlara rağmen, tekniklerin termal doğası ve tümesan anestezi gereksinimi, toplumda artan beklentilerle beraber daha iyi bir teknik arayışına yol açtı. İdeale en yakın yöntem, non-termal ve non-tümesan olan siyanoakrilat ablasyon terapisi gibi gözükmektedir. Kolay uygulanabilirliği ve en uzun takip süresi iki yıl olmak üzere, birinci seçenek terapötik yöntemlerle karşılaştırılabilir tatmin edici sonuçlara sahip olması ile siyanoakrilat ablasyon terapisi venöz yetmezliğin cerrahi tedavisinin geleceği olabilir. Yine de uzun takip süreli çalışmaların yapılması gereklidir.

What is popular may no longer be popular: Cyanoacrylate and other alternatives in surgical treatment of chronic venous insufficiency

With the beginning of 21st century, great advances in surgical treatment of venous insufficiency have been achieved including endovenous laser ablation and radiofrequency ablation methods. These methods became first line therapy alternatives also recommended by guidelines. Despite satisfactory results, the thermal nature and tumescent anesthesia requirement of the techniques initiated a search for a better technique with increasing expectations in society. The method closest to ideal seems to be cyanoacrylate ablation therapy that is non-thermal and non-tumescent. Having easy applicability and comparable satisfactory results with first line therapeutic methods with the longest follow-up of two years, cyanoacrylate ablation therapy may be the future for surgical treatment of venous insufficiency. Still, studies with long-term follow-up are needed to be conducted.

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