The Short-term Outcomes of Cyanoacrylate Embolization for Varicose Veins

Abstract

Purpose: The purpose of this study is to evaluate the short-term outcomes of cyanoacrylate embolization, evaluate the safety of the procedure, and compare the ultrasonography images of cyanoacrylate embolization and ablation cases. Cyanoacrylate embolization has been covered by insurance since 2019 and has become the new therapeutic option. We started using cyanoacrylate embolization in January 2020. Subjects and methods: The study included 26 limbs of 18 patients who underwent cyanoacrylate embolization for primary varicose veins between January and March 2020. The target vessels for treatment were the great and small saphenous veins. Varicectomy was not performed; elastic stockings were not used postoperatively. Anatomical, clinical, and safety evaluations were performed prospectively immediately and at 1 week, 1 month, and 3 months postoperatively. For the anatomical examination, the occlusion rate of the treated target vessels was evaluated using ultrasonography. The clinical examination included assessment of the visual analog scale (VAS) score for postoperative pain, venous clinical severity score (VCSS), and Aberdeen Varicose Vein Questionnaire (AVVQ) for the quality of life and safety evaluation. Results and discussion: The complete occlusion rate was 92.0% at 3 months postoperatively. The postoperative pain was mild, with a mean VAS score of 0.6±0.7. The mean VCSS improved from 2.1±1.3 at baseline to 0 within 3 month (p<0.001) . The mean AVVQ score improved from 8.0±9.0 at baseline to 1.2±3.3 within 3 month (p=0.002). Adverse events, namely, phlebitis, hypersensitivity, and hematoma rupture, occurred in 1 patient each. Conclusion: Cyanoacrylate embolization yielded favorable outcomes. As the surgery is performed without tumescent local anesthesia or the main body of the therapeutic device, it may be widely used in the future.