Ces radiol. 2018, 72(2):119-127 | DOI: 10.55095/CesRadiol2018/020

Modified embolization endovascular technique in the treatment of insufficient large and small saphena in symptomatic form of venous insufficiencyOriginal article

Karel Novotný¹, Miloslav Roček², Radek Pádr², Radim Pavlík², Michal Polovinčák², Theodor Adla², Petra Zimolová³, Jana Choi-Širůčková³, Martin Weis⁴, Simon Jirát⁵, Vilém Rohn¹

¹ Klinika kardiovaskulární chirurgie 2. LF UK a FN Motol, Praha

² Klinika zobrazovacích metod 2. LF UK a FN Motol, Praha

³ Kardiologická klinika 2. LF UK a FN Motol, Praha

⁴ Angiologická ambulance, Praha 6

⁵ Angiologie Zbraslav, Praha-Zbraslav

Goal: The embolization of large and small safena with modified N2-butylacrylate by commercially produced sets is currently the gentlest treatment method. We used a modified technique of applying Histoacryl and Lipiodol, commonly used to treat vascular malformations, tumors, or bleeding vessel.

Method: Over two years, 56 limbs were treated in 49 patients with insufficient saphena magna or saphena parva. In particular, patients with severe forms of venous insufficiency and patients with complicating comorbidities were enrolled in the study. The treatment was carried out by a modified technique of acrylate adhesive application.

Results: Immediate success rate was 98%. At the observed intervals of 6 weeks, 6 months, 1 year and 2 years, the anatomical success rate of occlusion (recanalization up to 5 cm from the junction) was 98, 96, 94, 94%. At the same intervals, the venous insufficiency status was evaluated by the Aberdeen Scoring Questionnaire and the American Venous Clinical Severity Score Venous Scoring System. In both cases, we showed improvement to 0.5% significance level in the two-year follow-up. Individual clinical signs of venous insufficiency were also evaluated. Risk factors of failure of the technique and post-operative complications are discussed. One patient experienced leakage of the adhesive into the lungs.

Conclusion: We have shown that treatment of large VSM and VSP embolization by Histoacryl has eliminated symptoms of venous insufficiency and efficacy in our patients comparable to commonly used methods.

Keywords: varicose veins, chronic venous insufficiency, Histoacryl, endovascular technique, venous ulcer

Accepted: April 4, 2018; Published: June 1, 2018  Show citation