A Novel Modified Technique with a Combination of Percutaneous Embolization with N-Butyl Cyanoacrylate and High Ligation of Saphenous Vein: a Preliminary Report

Abstract

Chronic venous insufficiency (CVI) is defined as a condition affecting the venous system of lower extremities. Different treatment options are used for the treatment of this pathological condition, which impairs quality of life, especially in later stages. Surgical options are used in the case of failure with conservative treatment and pharmacological methods. There are numerous surgical techniques used in the treatment of venous insufficiency. Each of these techniques has its advantages and disadvantages. New hybrid methods are being developed to overcome adverse effects and possible complications such as deep vein thrombosis, phlebitis, and infections. In the present study, we aimed to present the preliminary results of a combination of percutaneous embolization of SV with n-butyl cyanoacrylate (NBCA) and high ligation, which is a novel modified method that we have developed. A total of 47 patients, aged between 28 and 62 years and diagnosed with chronic venous insufficiency, were included in the study. The patients were evaluated with a Comprehensive Classification System For Chronic Venous Disorders, and Venous Clinical Severity Score (VCSS). Patients??? demographic features such as age and gender, and clinical features such as CEAP classes, VCSSs, and vena saphena magna VSM diameters were recorded. All patients were treated with a novel modified hybrid technique including Venablock embolization system (Invamed RD, Ankara, Turkey) and surgical high ligation of the greater SV. In addition, patients??? preprocedural, intraprocedural, and postprocedural period follow-up data were recorded and retrospectively analyzed. According to the CEAP classification, 38 patients (80.8%) were classified as C3, six patients (12.8%) as C4, and three patients (6.4%) as C2. CEAP class was C3 in majority (38/47) of the patients, with 22 (46.8%) female and 22 (53.2%) male patients in C3 class. The mean preoperative VCSS of the patients was calculated as 8.83????????1.31 and the mean postoperative VCSS was calculated as 2.85????????0.71. The mean postoperative VCSS was statistically significantly lower than the mean preoperative VCSS (p???<???0.05). The technical success rate was found as 100%. None of the patients developed complications or side effects. We suggest that this novel method is efficient and safe in the treatment of chronic venous insufficiency because it eliminates the need for general anesthesia with short operation time and adhesion of all branches of the saphenous vein, thus preventing possible complications.