Phlebologie 2014; 43(05): 242-248
DOI: 10.12687/phleb2216-5-2014
Original article
Schattauer GmbH

VenaSeal closure treatment of saphenous varicosis

Indication, technique, initial results Article in several languages: English | deutsch
J. Alm
1   Gefaessabteilung am Dermatologikum Hamburg, Germany
› Author Affiliations
Further Information

Publication History

Received: 16 July 2014

Accepted: 20 July 2014

Publication Date:
04 January 2018 (online)

Summary

Introduction: Treatment of saphenous varicosis with the VenaSeal Closure System requires no general or tumescent anaesthesia, nor is there any need for compression stockings to be worn. This paper reports on use, initial experience and 2-year results.

Material and method: From March 2012 to May 2014, 274 saphenous veins in 218 patients were treated with the VenaSeal Closure System. Doppler and duplex examinations were performed after 7 days, 6 weeks, 1 year and 2 years. Closure and complication rates, the pain score on a visual analogue scale and the venous clinical severity score (VCSS) were documented.

Results: Follow-up examinations were performed on 227 great saphenous veins (GSVs) and 24 small saphenous veins (SSVs). The closure rate of the GSVs was 99.5 % (n=227) after 7 days, 96.5 % after 6 weeks (n=172), 93.4 % after 1 year (n=61) and 100 % after 2 years (n=20). The closure rate of the SSVs was 100 % after 7 days (n=24), 6 weeks (n=12) and 1 year (n=4). No major complications occurred. Minor complications after treatment of the great saphenous vein were inflammatory reactions in 44 legs and phlebitis in 32 legs. During treatment, the pain score developed from 1.4 to 1.5 (3rd day), 2.1 (5th day), 1.6 (10th day), 0.2 (4 weeks) to 0.1 (6 weeks). Preoperatively, the VCSS was 4.4 and this value fell to 2.9 (7th day), 2.1 (6 weeks) and 1.8 (1 year and 2 years)

Discussion: The VenaSeal closure treatment of saphenous varicosis is safe and effective. The results are comparable to those obtained with thermal ablation procedures. In the absence of tumescent anaesthesia, patients have far fewer symptoms compared with thermal ablation procedures, both during treatment and postoperatively.

 
  • References

  • 1 Gloviczki P, Comerota AJ, Dalsing MC, Eklof BG, Gillespie DL, Gloviczki M. et al. The care of patients with varicose veins and associated chronic venous diseases: clinical practice guidelines of the Society for Vascular Surgery and the American Venous Forum. J Vasc Surg 2011; 53 (Suppl. 05) 2S-48S.
  • 2 National Institute for Health and Care Excellence. Varicose veins in the legs. The diagnosis and management of varicose veins (Internet). National institute for Health and Care Excellence. 2013. Available from: guidance.nice.org.uk/cg168
  • 3 Proebstle TM, Vago B, Alm J, Göckeritz O, Lebard C, Pichot O. Treatment of the incompetent great saphenous vein by endovenous radiofrequency powered segmental thermal ablation: first clinical experience. J Vasc Surg 2008; 47: 151-6.
  • 4 Levrier O, Mekkaoui C, Rolland PH, Murphy K, Cabrol P, Moulin G.. et al. Efficacy and low vascular toxicity of embolization with radical versus anionic polymerization of n-butyl-2-cyanoacrylate (NBCA). An experimental study in the swine. J Neuroradiol 2003; 30: 95-102.
  • 5 Vinters HV, Galil KA, Lundie MJ, Kaufmann JC. The histotoxicity of cyanoacrylates. A selective review. Neuroradiology 1985; 27: 279-291.
  • 6 Linfante I, Wakhloo AK. Brain aneurysms and arteriovenous malformations: advancements and emerging treatments in endovascular embolization. Stroke 2007; 38: 1411-1417.
  • 7 Min RJ, Almeida JI, McLean DJ, Madsen M, Raabe R. Novel vein closure procedure using a proprietary cyanoacrylate adhesive: 30-day swine model results. Phlebology 2012; 27: 398-403.
  • 8 Almeida JI, Min RJ, Raabe R, McLean DJ, Madsen M. Cyanoacrylate adhesive for the closure of truncal veins: 60-day swine model results. Vasc Endovascular Surg 2011; 45: 631-635.
  • 9 Lawson J, Gauw S, van Vlijmen C, Pronk P, Gaastra M, Mooij MWittens CHA. Sapheon: the solution. Phlebology 2013; 28 (Suppl. 01) 2-9.
  • 10 Almeida JI, Javier JJ, Mackay EG, Bautista C, Cher DJ, Proebstle TM. Two-year follow-up of first human use of cyanoacrylate adhesive for treatment of saphenous vein incompetence. Phlebology 2014 OnlineFirst Version-Apr 30. 2014
  • 11 Almeida JI, Javier JJ, Mackay EG, Bautista C, Cher DJ, Proebstle TM. First human use of cyanoacrylate adhesive for treatment of saphenous vein incompetence. J Vasc Surg 2013; 1: 174-180.
  • 12 Proebstle TM, Alm J, Rasmussen L, Dimitri S, Lawson JA, Whiteley M, Franklin IJ, Davies AH. The European Multicenter Study on Cyanoacrylate Embolization of Refluxing Great Saphenous Veins without Tumescent Anestesia and without Compression Therapy Tumeszenzanästhesie. J Vasc Surg: Venous and Lymphatic Disorders 2013; 1: 101
  • 13 Morrison M. Abstract for EVF Paris with oral presentation. 2014
  • 14 Rasmussen LH, Bjoern L, Lawaetz M, Lawaetz B, Blemings A, Eklof B. Randomised clinical trial comparing endovenous laser ablation with stripping of the great Saphenous vein: clinical outcome and recurrence after 2years. Eur J Vasc Endovasc Surg 2010; 39: 630-635.
  • 15 Roos MT, Borger van der Burg BLS, Wever JJ. Pain perception during and after VNUS ClosureFAST™ procedure. Phlebology 2011; 26: 209-212.
  • 16 Pronk P, Gauw SA, Mooij MC. et al. Randomised controlled trail comparing sapheno-femoral ligation and stripping of the great saphenous vein with endovenous laser ablation (980 nm) using local tumescent anaesthesia: one year results. Eur J Vasc Endovasc Surg 2010; 40: 649-656.
  • 17 Anwar MA, Lane TRA, Davies AH, Franklin IJ. Complications of radiofrequency ablation of varicose veins. Phlebology 2012; 27 (Suppl. 01) 34-39.
  • 18 Markides GA, Subar D, Al-Khaffaf H. Litigation claims in vascular surgery in the United Kingdom’s NHS. Eur J Vasc Endovasc Surg 2008; 36: 452-457.