Abstract

BackgroundNon-thermal non-tumescent methods for varicose vein treatment have rapidly gained popularity in recent years due to clinical efficacy comparable to other endovenous methods, but with a superior safety and tolerability profile. Cyanoacrylate is an adhesive that rapidly polymerises during endovenous treatment to cause rapid occlusion of veins and initiate vein fibrosis.MethodCyanoacrylate glue treatment is known to cause complications such as phlebitis, cellulitis and deep vein thrombosis in rare instances. We present the first reported case of cyanoacrylate extravasation with chronic foreign body reaction in a patient nine months after initial treatment.ResultsWe discuss the aetiology of this complication, its treatment, patient outcome and its significance to both clinicians and patients.ConclusionCyanoacrylate glue embolisation can, in rare instances, lead to extravasation and chronic foreign body reaction, necessitating surgical intervention. The relative novelty of cyanoacrylate glue embolisation in the treatment of varicose veins requires clinicians to monitor for rare complications during its use in clinical practice. Patients should be aware of the rare risk of glue extravasation and foreign body reaction for fully informed consent prior to treatment.

Highlights

  • Cyanoacrylate glue embolisation is a comparatively novel endovenous method for treating varicose veins

  • We report the first documented case of delayed extravasation and chronic foreign body reaction following the use of cyanoacrylate glue and discuss its importance for both clinicians and patients

  • Cyanoacrylate glue appears to be a safe method of treatment, with a low rate of complications reported in clinical studies.[6]

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Summary

Introduction

Cyanoacrylate glue embolisation is a comparatively novel endovenous method for treating varicose veins. A 54-year-old woman presented with a three-week history of a painless lump in the anteromedial aspect of her left thigh Nine months previously she had undergone endovenous glue embolisation (VenaSeal Closure System – MedTronic, USA) of her left great saphenous vein (GSV) under local anaesthetic for CEAP C4a chronic venous disease. Examination of the patient in clinic identified multiple hard, non-tender lumps in the anteromedial aspect of the superior to middle thigh, with one visible area of erythema that had developed progressively over three weeks but no associated discharge (Figure 1). This site was more than 15 cm proximal to the cannulation site. She will continue to be monitored to assess the need for further intervention

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