Abstract
Background: The current treatment of venous disease is focused on the minimally invasive exclusion of the affected vein. Besides widely used thermal ablation, chemical ablation with cyanoacrylate, reported as safe and highly effective, has been gaining increasing interest. Patients and methods: In the current report, we present data from a two-year observation in 89 patients (61 female/28 male, mean age 44.3 ± 13.5) suffering from venous insufficiency (C2–C4), treated either using short-chain cyanoacrylate, the VenaBlock system (n = 43) or laser thermoablation with ELVeS 1470 (n = 46). The assessment comprised the occurrence of venous disease-related symptoms and the ultrasound examination of the leg venous system. Results: The frequency of recanalization after 2 years from the VenaBlock procedure was significantly higher than after laser treatment (37.2 vs. 8.7%). Apart from recanalization, in some individuals from both groups, the symptoms of recurrence and/or disease progression, including the development of insufficiency in other veins of treated or contralateral legs (9.3 vs. 15.2% and 9.3 vs. 17.4%, respectively), were observed. Unexpectedly, the general prevalence of the disease progression did not differ significantly between the VenaBlock and ELVeS groups (44.2 vs. 34.8%, respectively). Conclusions: Despite the higher recanalization rate of VenaBlock compared to ELVeS, the overall effectiveness of cyanoacrylate and laser thermoablation after two years was similar. Therefore, both methods similarly failed to prevent recurrence and disease progression, which seem to be method-independent.
Highlights
Chronic venous disease (CVD) is a common clinical problem, especially in industrialized countries
The first two mentioned advantages result from no need for a time-consuming tumescent anesthesia
The duration of the vein ablation procedure using the first system which has been introduced into the market (VenaSeal) is similar or a bit shorter than that of laser thermoablation, mainly due to the slow polymerization of the obliterating agent
Summary
Chronic venous disease (CVD) is a common clinical problem, especially in industrialized countries. Thermal methods include radiofrequency- and laser-based ablation, whereas non-thermal techniques comprise foam and liquid sclerotherapy, mechano-chemical obliteration, or the recently introduced endovenous application of cyanoacrylate [6,7,8]. The latter was announced as highly effective in the treatment of truncal insufficiency of large superficial veins—mainly great saphenous (GSV) and anterior accessory saphenous veins (AASV) [8,9,10]. Conclusions: Despite the higher recanalization rate of VenaBlock compared to ELVeS, the overall effectiveness of cyanoacrylate and laser thermoablation after two years was similar Both methods failed to prevent recurrence and disease progression, which seem to be method-independent
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