Summary
Introduction: Treatment of saphenous varicosis with the VenaSeal™ Closure System requires no general or tumescent anaesthesia, nor is there any need for compression stockings to be worn. This paper reports on use, initial experience and 2-year results.
Material and method: From March 2012 to May 2014, 274 saphenous veins in 218 patients were treated with the VenaSeal™ Closure System. Doppler and duplex examinations were performed after 7 days, 6 weeks, 1 year and 2 years. Closure and complication rates, the pain score on a visual analogue scale and the venous clinical severity score (VCSS) were documented.
Results: Follow-up examinations were performed on 227 great saphenous veins (GSVs) and 24 small saphenous veins (SSVs). The closure rate of the GSVs was 99.5 % (n=227) after 7 days, 96.5 % after 6 weeks (n=172), 93.4 % after 1 year (n=61) and 100 % after 2 years (n=20). The closure rate of the SSVs was 100 % after 7 days (n=24), 6 weeks (n=12) and 1 year (n=4). No major complications occurred. Minor complications after treatment of the great saphenous vein were inflammatory reactions in 44 legs and phlebitis in 32 legs. During treatment, the pain score developed from 1.4 to 1.5 (3rd day), 2.1 (5th day), 1.6 (10th day), 0.2 (4 weeks) to 0.1 (6 weeks). Preoperatively, the VCSS was 4.4 and this value fell to 2.9 (7th day), 2.1 (6 weeks) and 1.8 (1 year and 2 years)
Discussion: The VenaSeal™ closure treatment of saphenous varicosis is safe and effective. The results are comparable to those obtained with thermal ablation procedures. In the absence of tumescent anaesthesia, patients have far fewer symptoms compared with thermal ablation procedures, both during treatment and postoperatively.
Keywords
Venous adhesive - endovenous treatment - varicose veins - cyanoacrylate adhesive - catheter technique