Post-operative Compression Therapy Could Reduce the Incidence of Phlebitis on Cyanoacrylate Embolization for Varicose Veins

Abstract

Cyanoacrylate (CA) embolization is the treatment to eliminate reflux due to venous valve insufficiency of truncal varicose veins. CA delivered into the vein, elicits a granulomatous foreign body reaction and a concomitant inflammatory vein wall reaction, leading to subsequent fibrotic degradation. Even though CA embolization does not require compression therapy, post-procedure phlebitis has been reported in about 10% of patients. In contrast, as we have continued post-operative compression therapy after CA embolization, the incidence of phlebitis was lower than that of other reports. Actual procedure was to put the compression pads (compression pressure about 50 mmHg) along the overlying skin on the embolized saphenous vein and to apply the elastic bandage. Next morning, the bandage and pads were removed and the elastic stockings should be worn during daytime for 4 weeks. During January to December 2021, the incidence of phlebitis was investigated in 115 patients (28 male, 87 female, mean age 67.5 years old), 141 legs (114 great saphenous, 27 small saphenous veins). Three cases (2.1%) had skin redness like allergic reaction over the treated saphenous veins. Thrombo-phlebitis has occurred in two cases (1.4%) of varices, at non-injected site of CA. In conclusion, the incidence of post-procedure phlebitis could be reduced by continuous post-operative compression therapy for CA embolization treatment of varicose veins.