Chemical ablation as successful alternative for treatment of incompetent perforators

Cvetanovski, Vlatko and cimjeschikj, Dina and Cvetanovska, Marija and Arsovski, Andreja and Mitevski, Aleksandar (2023) Chemical ablation as successful alternative for treatment of incompetent perforators. Makedonski medicinski pregled, 77 (3). pp. 144-148. ISSN 0025-1097

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Abstract

Introduction. Superficial venous incompetence (SVI) is the most common cause of lower extremity super-ficial venous reflux and varicose veins; nonetheless, incompetent perforator veins (PVs) are the most co-mmon cause of recurrent varicose veins after treat-ment, often unrecognized. Current minimally invasive treatment options include ultrasound-guided sclerothe-rapy (USGS), endovascular thermal ablation (EVTA) with either laser or radiofrequency energy sources, subfascial endoscopic perforator surgery (SEPS) and the relatively new chemical ablation procedure using cyanoacrylate adhesive, which we chose as our pri-mary treatment option for this study, using and com-paring the results of two different adhesives. Methods. A retrospective review of a prospectively managed database of chemical ablation as perforator vein treatment performed at a single institution from September 2023 to March 2024 was conducted. The indications for PV treatment were >4 mm in diameter and reflux of >500 milliseconds upon leg compression. Results. A total of 32 patients and 49 limbs presenting PV insufficiency (coexisting with GSV insufficiency in 19 patients) were divided into 2 groups of 16 patients, each group based on the chosen chemical ablation adhesive - VenaBlock and VenaSeal. The VenaBlock group had PV closure rate of 100% immediately intra-operative, at 3 days, 2 weeks, 3 weeks and 1 month from the procedure for each treater perforator. From the VenaSeal group, 13 patients had immediate and con-tinuous treatment success during the follow-up, while in 3 patients there was intraoperatively registered treat-ment failure (P=0.0127).
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Correspondence to: Dina Cimeshikj, Department of Vascular Surgery at General Hospital Remedika, 1000 Skopje, R. N. Macedonia; E-mail: dina.cimesik@gmail.com Conclusion. We find the chemical ablation procedure to be safe and effective for PVs, specifically in the case of using rapid polymerization adhesive. Due to its sim-plicity and short procedural time, we consider this to be the procedure of choice in case of multiple incompe-tent PVs present, as well as in significant PV tortuosity.
Keywords: superficial venous incompetence, perforating veins, chemical ablation, VenaSeal, VenaBlock

Item Type:	Article
Subjects:	Medical and Health Sciences > Clinical medicine
Divisions:	Faculty of Medical Science
Depositing User:	Aleksandar Mitevski
Date Deposited:	16 Dec 2024 13:24
Last Modified:	16 Dec 2024 13:24
URI:	https://eprints.ugd.edu.mk/id/eprint/35260

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