Predictors of Recanalization for Incompetent Great Saphenous Veins Treated with Cyanoacrylate Glue

Abstract

PurposeTo determine predictors of recanalization in patients treated with endovenous cyanoacrylate. MethodsFollow-up by serial clinical and duplex examinations was performed at 1 week, 1 month, 6 months, 12 months, and 24 months of 108 legs in 55 patients (21 men, median age 65 y) with primary varicose veins treated with endovenous cyanoacrylate. Cox regression analysis was used to examine venous characteristics before the procedure: diameter of great saphenous vein (GSV), treatment length of GSV, presence of incompetent perforators, clinical severity of varicose vein, and experience of operator as predictors of recanalization. With the patient in supine position, GSV diameter was measured at 3 levels (proximal thigh 1 cm from saphenofemoral junction, midthigh, and distal thigh above knee). ResultsOf 108 legs, 2 had minimal extension of thrombus to deep vein, and 4 had superficial thrombophlebitis. Kaplan-Meier analysis showed GSV closure rates were 97.2%, 92.3%, 89.2%, and 75.7% at 1 week, 1 month, 6 months, and 12 months after the procedure. With a median follow-up period of 5 months (range, 0–18 months), 4 legs had clinical recurrence. Mean GSV diameter ≥ 6.6 mm was the only significant predictor for recanalization (hazard ratio 12.1; 95% CI, 1.6–92.7; P = .016). ConclusionsThe use of endovenous cyanoacrylate to treat varicose veins caused by incompetent GSV was safe. GSVs < 6.6 mm in diameter had a closure rate of 90.0% at 12 months. Despite 97.2% closure rates at 1 week, recanalization was observed in GSVs with larger diameter.