Cyanoacrylate ablation for chronic venous disease: a review and future applications

Kathleen Ozsvath, MD, FACS Chief of Surgery, Samaritan Hospital, Troy, New York; Vascular Associates, St Peters Health Partners, Albany, New York; Professor of Surgery, Albany Medical Center, Albany, New York, USA ABSTRACT Many endovenous procedural modalities exist today, including endovenous thermal ablation (laser ablation, [EVLT] and radiofrequency ablation [RFA]), nonthermal nontumescent ablation, and ultrasound-guided sclerotherapy (UGS) and chemical ablation. Recently, cyanoacrylate has been used for the treatment of axial insufficiency. The most studied preparation of N-butyl cyanoacrylate is VenaSeal (Medtronic), which has been compared with the other ablative techniques. These studies have shown excellent results with patient satisfaction, outcomes, and…

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Varicose veins during pregnancy: risk factors and impact on quality of life

Sena Dilek Aksoy, PhD, RN Department of Midwifery, Faculty of Health Science, Kocaeli University, Kocaeli, Turkey Derya Kanza Gul, MD School of Medicine Health, Medipol University, Istanbul, Turkey Ayça Solt Kirca, PhD, RM Department of Midwifery, School of Health, Kirklareli University, Kirklareli, Turkey ABSTRACT Objective: This study was carried out to examine the risk factors for varicose veins during pregnancy and their impact on quality of life. Material and methods: This was a prospective, cross-sectional observational study in pregnant women in their second and third trimesters. In addition to the collection of sociodemographic and lifestyle data, the presence of varicose…

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Chronic pelvic pain anpelvic venous disorders: the gynecologist’s point of view

Aleksandra Jaworucka-Kaczorowska, MD, PhD Center of Phlebology and Aesthetic Medicine, Center of General and Vascular Surgery, Gynecology and Obstetrics “Jaworuccy”, Gorzów Wlkp, Poland ABSTRACT Chronic pelvic pain (CPP) is a very common symptom with multiple potential etiologies. Very often, it is the result of an overlap of several pain-generating disorders of the reproductive tract, gastrointestinal system, urological organs, musculoskeletal system, and psychoneurological system. Living with CPP carries a heavy economic and social burden. Due to the complex etiology of CPP, to achieve good treatment results, the approach should be multimodal and requires a cooperative interdisciplinary team of clinicians, including gynecologists,…

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Management of hypodermitis or lipodermatosclerosis: an up-to-date review

Lourdes Reina-Gutierrez, MD Medical Doctor specialized in Angiology and Vascular Surgery, Head of the Angiology and Vascular Department of University Hospital Central de la Cruz Roja, Madrid, Spain and Professor of Medicine Grade in Alfonso X el Sabio University Alfonso Sanjuanbenito-Reina, MD Medical Doctor at University Hospital Ramon y Cájal, Madrid, Spain ABSTRACT Hypodermitis or lipodermatosclerosis (LDS) is a chronic inflammatory process of the dermis and subcutaneous layer in the legs of patients with advanced chronic venous disease (CVD). It is one of the clinical findings for class C4b in the CEAP classification (clinical, etiological, anatomical, and pathophysiological) of CVD….

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Endovenous laser ablation or radiofrequency ablation for varicose veins: a review

Sushil DAHAL, MBBS; Robin Man KARMACHARYA, MS; Satish VAIDYA, MS; Prasesh DHAKAL, MBBS; Niroj BHANDARI, MBBS; Sahil BADE, MBBS; Sohail BADE, MBBS; Selene POKHAREL, MBBS; Shreeja SHIKHRAKAR, MBBS; Prabha SHRESTHA, MSN; Department of Surgery, Dhulikhel Hospital, Kathmandu University Hospital, Kavre, Nepal Abstract Varicose veins are a part of chronic venous insufficiency syndrome, presenting with dilated veins, skin changes, and even ulceration in the lower limbs. Untreated, it can result in many complications and has an impact upon one’s quality of life. Management depends upon the stage and etiology of varicose veins. Conventional vein stripping surgery is now being replaced by…

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Update on treatment methods for telangiectasia

Mesut ENGIN, MD, Assoc Prof; University of Health Sciences, Bursa Yuksek Ihtisas Training and Research Hospital, Department of Cardiovascular Surgery, Turkey Abstract Telangiectasias make up a heterogeneous group of diseases that can affect various parts of the body in humans. Although generally limited to the face, telangiectasia can cover different parts of the body in various collagen tissue diseases. The appropriate treatment options for telangiectasias are sclerotherapy, laser therapy, thermocoagulation, and microphlebectomy. The purpose of sclerotherapy is to cause endothelial damage by injecting a sclerosing agent into the vascular bed. Agents such as polidocanol, sodium tetradecyl sulfate, hypertonic saline, and…

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Is it essential to treat the AASV during thermal ablation of the GSV?

Anne-Sophie LENSEL, MD; Jean-Luc GERARD, MD; Clinique du Mont-Louis, Paris Clinique Geoffroy Saint-Hilaire, Paris Abstract Recent decades have experienced the substantial development of endovenous techniques to treat varicose veins. Such techniques are guided by ultrasound through use of increasingly efficient equipment, and operators have become better trained. This, in parallel with the study of cadaver dissections, has led to a marked improvement in the knowledge of vein anatomy in the lower limbs. The treatment of varicose veins has always been known for its risk of recurrence, which can have several origins. The most widely accepted cause right now is recurrence…

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Factors impeding venous return and their impact on the management of chronic venous disease

RAshna RAIKER, BS; Nicos LABROPOULOS, PhD2; 1Department of Surgery, Stony Brook University Medical Center, New York, USA Abstract Chronic venous disease is multifactorial. Although the main pathology of chronic venous disease is reflux and obstruction, several other factors play a role as well. These include the duration, distribution, and extent of disease, but also additional factors such as obesity, and musculoskeletal and heart failure. This is especially important for those with advanced disease, as these factors that impede venous return may be more common. In fact, there are reports where people do not have evidence of venous disease but still…

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Pharmacological correction of total venous reflux in patients with varicose veins

Nikolai KHOREV,1 MD, PhD; Darya KUZNETSOVA,2 MD, PhD 1Department of Cardiology and Cardiovascular Surgery, Altai State Medical University, Barnaul, Russia 2Department of Pathological Anatomy, Department of Pathophysiology Altai State Medical University, Barnaul, Russia Abstract The study was aimed at evaluating the efficacy of micronized purified flavonoid fraction (MPFF) in patients with primary chronic venous disease (CVD). It included 35 patients with varicose veins of the lower extremities (18 with bilateral and 7 with unilateral lesion). A total of 53 legs with varicose veins were evaluated in 3 groups based on the CEAP (Clinical, Etiology, Anatomic, Pathophysiology classification system) clinical class:…

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Cyanoacrylate closure in the treatment of varicose veins – what is the evidence?

Nick MORRISON, MD, FACS, DBVLM Center for Vein Restoration, Phoenix, Arizona, USA Abstract Introduction Cyanoacrylate ablation for incompetent saphenous veins is a recent addition to the armamentarium of venous surgeons. It does not require the instillation of tumescent anesthesia during the procedure, thus reducing patient discomfort, and neither are compression hose necessary after treatment. Early cyanoacrylate ablation trials VenaSeal™ (Medtronic, Minnesota, USA) was the first reported use of a formulation of cyanoacrylate used in the ablation of incompetent saphenous veins. Clinical series and randomized controlled clinical trials demonstrated the safety and efficacy of this ablation method. The VeClose trial compared…

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