EFFECT OF CYANOACRYLATE VEIN CLOSURE ON VENOUS CLINICAL SEVERITY SCORE IN SUPERFICIAL VENOUS INSUFFICIENCY: ONE-MONTH FOLLOW-UP

Authors

  • Sashko Nikolov Faculty of Medical Sciences, Goce Delcev University, Stip, North Macedonia
  • Ana Marija Taseva Vasileva Faculty of Medical Sciences, Goce Delcev University, Stip, North Macedonia

Keywords:

Cyanoacrylate ablation, superficial venous insufficiency, chronic venous disease, VCSS, minimally invasive treatment

Abstract

Background: Cyanoacrylate ablation (CA) is a novel, non-thermal, non-tumescent (NTNT) technique for treating superficial venous insufficiency. It offers the advantage of permanent vein occlusion without anesthesia, thermal energy, or postoperative compression. Although large multicenter studies have confirmed its safety and efficacy, data from smaller single-center experiences remain limited. This study aimed to evaluate early anatomical and clinical outcomes of cyanoacrylate ablation in an ambulatory population.
Methods: This prospective single-center study included 31 patients with symptomatic superficial venous insufficiency who underwent cyanoacrylate ablation of the great or small saphenous vein. Patients were evaluated clinically and with duplex ultrasound at baseline and at one month post-procedure. Clinical improvement was assessed using the Venous Clinical Severity Score (VCSS). Statistical analysis was performed using paired tests, with p < 0.05 considered significant.
Results: Complete anatomical closure of all treated veins was confirmed by duplex ultrasound at one month, yielding a 100% technical success rate. No cases of deep vein thrombosis, thrombophlebitis, or infection were recorded. The median total VCSS decreased significantly from 5 to 3 (p = 0.00002), with marked improvement in pain (2→0; p = 0.00003), edema (2→1; p = 0.005), and inflammation (≥2→0; p = 0.043). Other domains, including pigmentation and induration, showed no significant early change.
Conclusion: Cyanoacrylate ablation achieved complete vein closure and significant short-term clinical improvement with no major complications. The absence of tumescent anesthesia, thermal injury, and postoperative compression enhances patient comfort and accelerates recovery. These findings confirm cyanoacrylate ablation as a safe, effective, and well-tolerated minimally invasive option for the treatment of superficial venous insufficiency.

References

Almeida, J. I., Javier, J. J., Mackay, E. G., Bautista, C., Cher, D. J., & Proebstle, T. M. (2015). Two-year follow-up of first human use of cyanoacrylate adhesive for treatment of saphenous vein incompetence. Phlebology, 30(6), 397–404. https://doi.org/10.1177/0268355514532455

Almeida, J. I., Javier, J. J., Mackay, E. G., Bautista, C., Cher, D. J., & Proebstle, T. M. (2017). Thirty-sixth-month follow-up of first-in-human use of cyanoacrylate adhesive for treatment of saphenous vein incompetence. Journal of Vascular Surgery: Venous and Lymphatic Disorders, 5(5), 658–666. https://doi.org/10.1016/j.jvsv.2017.03.016

Amshar, M., Nugraha, R. A., Batubara, E. A. D., Siddiq, T., Indriani, S., & Adiarto, S. (2022). Cyanoacrylate embolization versus endovenous laser ablation in treating saphenous vein insufficiency: A systematic review and meta-analysis. Annals of Vascular Surgery, 80, 313–324. https://doi.org/10.1016/j.avsg.2021.09.041

Ay, Y., Gunes, E., Turkkolu, S. T., Selcuk, E., Calim, M., Akal, R., Aydin, C., Inan, B., Koksal, C., & Kahraman Ay, N. (2021). Comparative efficacy and life quality effects of surgical stripping, radiofrequency ablation, and cyanoacrylate embolization in patients undergoing treatment for great saphenous vein insufficiency. Phlebology, 36(1), 54–62. https://doi.org/10.1177/0268355520947292

Beebe-Dimmer, J. L., Pfeifer, J. R., Engle, J. S., & Schottenfeld, D. (2005). The epidemiology of chronic venous insufficiency and varicose veins. Annals of Epidemiology, 15(3), 123–130. https://doi.org/10.1016/j.annepidem.2004.05.015

Eberhardt, R. T., & Raffetto, J. D. (2014). Chronic venous insufficiency. Circulation, 130(4), 333–346. https://doi.org/10.1161/CIRCULATIONAHA.113.006898

García-Carpintero, E., Carmona, M., Chalco-Orrego, J. P., González-Enríquez, J., & Imaz-Iglesia, I. (2020). Systematic review and meta-analysis of endovenous cyanoacrylate adhesive ablation for incompetent saphenous veins. Journal of Vascular Surgery: Venous and Lymphatic Disorders, 8(2), 287–296. https://doi.org/10.1016/j.jvsv.2019.09.010

Gibson, K., & Ferris, B. (2017). Cyanoacrylate closure of incompetent great, small, and accessory saphenous veins without the use of post-procedure compression: Initial results from the WAVES study. Vascular, 25(5), 442–450. https://doi.org/10.1177/1708538117696575

Gibson, K., Ferris, B., McEnroe, S., Weiss, R., Vasquez, M., & Morrison, N. (2018). Twenty-four-month results from a randomized trial of cyanoacrylate closure versus radiofrequency ablation for incompetent great saphenous veins (VeClose). Journal of Vascular Surgery: Venous and Lymphatic Disorders, 6(5), 606–613. https://doi.org/10.1016/j.jvsv.2018.03.007

Guo, J., Zhang, F., Guo, J., Guo, L., Gu, Y., & Huang, Y. (2021). A systematic review and meta-analysis comparing the efficacy of cyanoacrylate ablation over endovenous thermal ablation for treating incompetent saphenous veins. Phlebology, 36(8), 597–608. https://doi.org/10.1177/02683555211008762

Güven, C., & Baykan, A. (2020). Comparison of stripping/ligation and embolization with cyanoacrylate in venous insufficiency treatment. Journal of Surgery and Medicine, 4(5), 400–405. https://doi.org/10.28982/josam.732821

Joh, J. H., Lee, T., Byun, S. J., Cho, S., Park, H. S., Yun, W. S., Yang, S. S., Kim, H., Kim, W. S., & Jung, I. M. (2022). A multicenter randomized controlled trial of cyanoacrylate closure and surgical stripping for incompetent great saphenous veins. Journal of Vascular Surgery: Venous and Lymphatic Disorders, 10(2), 353–359. https://doi.org/10.1016/j.jvsv.2021.08.012

Morrison, N., Gibson, K., McEnroe, S., Goldman, M., King, T., Weiss, R., Cher, D., & Almeida, J. I. (2015). Randomized trial comparing cyanoacrylate embolization and radiofrequency ablation for incompetent great saphenous veins (VeClose). Journal of Vascular Surgery, 61(4), 985–994. https://doi.org/10.1016/j.jvs.2014.11.071

Morrison, N., Gibson, K., Vasquez, M., Weiss, R., Cher, D., Madsen, M., & Jones, A. (2017). VeClose trial 12-month outcomes of cyanoacrylate closure versus radiofrequency ablation for incompetent great saphenous veins. Journal of Vascular Surgery: Venous and Lymphatic Disorders, 5(3), 321–330. https://doi.org/10.1016/j.jvsv.2016.12.005

Morrison, N., Gibson, K., Vasquez, M., Weiss, R., & Cher, D. (2019). Thirty-six-month outcomes of the VeClose randomized controlled trial. Journal of Vascular Surgery: Venous and Lymphatic Disorders, 7(5), 779–789. https://doi.org/10.1016/j.jvsv.2019.04.001

Morrison, N., Gibson, K., Vasquez, M., Weiss, R., & Cher, D. (2020). Five-year extension study of cyanoacrylate closure versus radiofrequency ablation for incompetent great saphenous veins: 60-month results from the VeClose trial. Journal of Vascular Surgery: Venous and Lymphatic Disorders, 8(6), 978–989. https://doi.org/10.1016/j.jvsv.2020.03.013

Nesbitt, C., Bedenis, R., Bhattacharya, V., & Stansby, G. (2014). Endovenous ablation (radiofrequency and laser) and foam sclerotherapy versus open surgery for great saphenous vein varices. Cochrane Database of Systematic Reviews, 2014(7), Article CD005624. https://doi.org/10.1002/14651858.CD005624.pub3

Proebstle, T. M., Alm, J., Dimitri, S., Rasmussen, L., Whiteley, M., Lawson, J., Cher, D., & Davies, A. (2015). The European multicenter cohort study on cyanoacrylate embolization of refluxing great saphenous veins. Journal of Vascular Surgery: Venous and Lymphatic Disorders, 3(1), 2–7. https://doi.org/10.1016/j.jvsv.2014.09.001

Rasmussen, L. H., Lawaetz, M., Bjoern, L., Vennits, B., Blemings, A., & Eklof, B. (2011). Randomized clinical trial comparing endovenous laser ablation, radiofrequency ablation, foam sclerotherapy, and surgical stripping for great saphenous varicose veins. British Journal of Surgery, 98(8), 1079–1087. https://doi.org/10.1002/bjs.7555

Downloads

Published

2025-12-15

How to Cite

Nikolov, S., & Taseva Vasileva, A. M. (2025). EFFECT OF CYANOACRYLATE VEIN CLOSURE ON VENOUS CLINICAL SEVERITY SCORE IN SUPERFICIAL VENOUS INSUFFICIENCY: ONE-MONTH FOLLOW-UP. KNOWLEDGE - International Journal , 73(4), 659–663. Retrieved from https://ojs.ikm.mk/index.php/kij/article/view/8032