A new application of external valvuloplasty using interventional injection of N-butyl cyanoacrylate for malfunctioning venous valves

Erhan Hafız; Elzem Sen

doi:10.28982/josam.796153

Authors

Erhan Hafız https://orcid.org/0000-0002-0801-3194
Elzem Sen https://orcid.org/0000-0003-3001-7324

DOI:

https://doi.org/10.28982/josam.796153

Keywords:

Chronic venous insufficiency, incompetent venous valve, treatment, external gel application

Abstract

Aim: Chronic venous insufficiency (CVI) is a common disorder that occurs when the venous valves are not working sufficiently. The treatment strategies depend on ameliorating the function of the valves. The aim of this study was to evaluate the external application of N-Butyl Cyanoacrylate to improve venous valves’ functions. Methods: Thirty patients with CVI who were admitted to the cardiovascular surgery clinic with CVI complaints and underwent extravenous N-Butyl Cyanoacrylate application (extravenous application to the area surrounding the malfunctioning venous valves) between January 2020 and June 2020 were included in this retrospective cohort study. Preoperative and postoperative (third and sixth month) venous Doppler ultrasound findings and complaints were noted, and the results were compared. Results: The diameter of the great saphenous vein was found to have decreased during the postoperative period (9.27 (1.95 mm) vs. 6.27 (2.16), P=0.001). Decremental saphenofemoral reflux durations were detected in postoperative ultrasound evaluations when compared with preoperative data (0.77(0.87) vs. 4.77(0.97) seconds). CVI complaints, including oedema, pigmentation and restless leg syndrome, improved within months after the operation. Conclusion: The external application of N-Butyl Cyanoacrylate gel seems effective for recovering venous valve function in the medium term.

Downloads

Download data is not yet available.

References

Sándor T. Chronic venous disease. A state of art. Orv Hetil. 2010;151:131-9.

Ross DS. Venous stasis ulcers: a review. Northeast Florida Medicine. 2012;63:29-51.

Eberhardt RT, Raffetto JD. Chronic venous insufficiency. Circulation. 2005;111:2398-409.

Santler B, Goerge T. Chronic venous insufficiency - a review of pathophysiology, diagnosis, and treatment. J Dtsch Dermatol Ges. 2017;15(5):538-56. doi: 10.1111/ddg.13242

van Gent WB, Catarinella FS, Lam YL, Nieman FH, Toonder IM, van der Ham AC, et al. Conservative versus surgical treatment of venous leg ulcers: 10-year follow up of a randomized, multicenter trial. Phlebology. 2015;30(1 Suppl):35-41. doi: 10.1177/0268355514568848

Derin Çiçek E, Arslan HM. The efficacy of external valvuloplasty with silicone stents (Venocuff™) in the management of focal valvular incompetence as assessed by Doppler ultrasound. Turk J Vasc Surg. 2020;29(3):152-8.

Lane RJ, Cuzzilla ML, Coroneos JC, Phillips MN, Platt JT. Recurrence rates following external valvular stenting of the saphenofemoral junction: a comparison with simultaneous contralateral stripping of the great saphenous vein. Eur J Vasc Endovasc Surg. 2007;34(5):595-604. doi:10.1016/j.ejvs.2007.06.021

Lane RJ, Graiche JA, Coroneos JC, Cuzzilla ML. Long-term comparison of external valvular stenting and stripping of varicose veins. ANZ J Surg. 2003;73(8):605-9. doi:10.1046/j.1445-2197.2003.02714.x

Karahan O, Yavuz C, Kankilic N, Demirtas S, Tezcan O, Caliskan A, et al. Simple blood tests as predictive markers of disease severity and clinical condition in patients with venous insufficiency. Blood Coagul Fibrinolysis. 2016;27(6):684-90. doi:10.1097/MBC.0000000000000478

Song IK, Kim EH, Lee JH, Jang YE, Kim HS, Kim JT. Seldinger vs modified Seldinger techniques for ultrasound-guided central venous catheterisation in neonates: a randomised controlled trial. Br J Anaesth. 2018;121(6):1332-7. doi:10.1016/j.bja.2018.08.008

Yavuz C, Demirtas S, Guclu O, Karahan O, Yazici S, Caliskan A, et al. An alternative therapy for recurrent stasis ulcers in chronic venous insufficiency: venocuff. Case Rep Vasc Med. 2012;2012:315147. doi:10.1155/2012/315147

Goel RR, Abidia A, Hardy SC. Surgery for deep venous incompetence. Cochrane Database Syst Rev. 2015;2015(2):CD001097.

Hardy SC, Riding G, Abidia A. Surgery for deep venous incompetence. Cochrane Database Syst Rev. 2004;(3):CD001097. doi:10.1002/14651858.CD001097.pub2

Joh JH, Lee KB, Yun WS, Lee BB, Kim YW, Kim DI. External banding valvuloplasty for incompetence of the great saphenous vein: 10-year results. International Journal of Angiology. 2009;18(1):25–8.

Sarac A, Jahollari A, Talay S, Ozkaya S, Ozal E. Long-term results of external valvuloplasty in adult patients with isolated great saphenous vein insufficiency. Clin Interv Aging. 2014;9:575-9. doi:10.2147/CIA.S60555

Zamboni P, Marcellino MG, Cappelli M, Feo CV, Bresadola V, Vasquez G, et al. Saphenous vein sparing surgery: principles, techniques and results. J Cardiovasc Surg (Torino) 1998;39:151-62.

Ragg JC: A New Modality to Shape Enlarged Veins and Restore Valves by Perivenous Injection of Viscous Fluids. J Am Coll Cardiol Intv 2014;7:S33.