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Treatment Length And Allergies Are Not Associated With Post-operative Hypersensitivity In The Veteran's Affair's Population Treated With Cyanoacrylate Glue Closure
Taylor Orton, MD, Carla Isabella Miret Durazo, MD, Oluwaseun Awosanya, Vincent Hu, Stephen Kubaska, MD, Nii-Kabu Kabutey, MD, Anthony Chau, MD.
Tibor Rubin Medical Center Veteran's Affairs, Long Beach, CA, USA.
OBJECTIVESCyanoacrylate glue closure (CAC) of lower extremity veins is an effective treatment option with reported 3 year closure rates above 95%. The most common adverse event (AE) after CAC being phlebitis with reports from 1.2% to 25%. The cause of this phlebitis is unclear, but thought to be a type of hypersensitivity reaction (HR), as it differs in characterization from phlebitis seen in other venous treatments. The purpose of this study was to evaluate the safety and efficacy of CAC in the Veteran Affairs patient population. METHODSA single center, retrospective review of all venous insufficiency CAC of either the greater saphenous vein or small saphenous vein from 12/2022 to 7/2025 was performed. Primary end points were technical success and safety. Secondary endpoints include minor AE. RESULTSA total of 66 limbs in 56 patients with symptomatic, ultrasound-confirmed venous reflux were treated with CAC during the study period. 23
(35% limbs or 41% patients
) were classified as CEAP 4 or higher. Mean age was 68.6. The most common comorbidities included hypertension, diabetes mellitus, chronic kidney disease, obesity, and atrial fibrillation. The average treatment length was 55.7 cm. 49% of patients had a preexisting allergy.
Concurrent stab phlebectomy was done in 22/66 (34%) cases.Technical success was found in 63/65 (97%) of cases, with two cases being aborted due to vasospasm before CAC injection. One (1.6%) patient died due to heart failure exacerbation 21 days following their vein ablation with a negative DVT/PE study. One (1.6%) patient was diagnosed with a femoral/popliteal DVT without clot seen at the saphenofemoral junction. The overall minor AE rate was 9/64 cases (14%). Of that, six patients (9%) had mild HR. One patient (1.6%) had a minor bleeding event. Two (3.1%) patients complained of transient numbness at stab phlebectomy sites. One (1.6%) patient had a posterior tibial DVT. There were zero incidences of Endovenous Glue-Induced Thrombus. There were no statistically significant associations to treatment length or preexisting patient allergies.CONCLUSIONSOur single center complication and HR rates are similar to previously published studies. There was not an association between treatment length or perioperative allergies to developing HR. CAC is safe and effective treatment modality for long segment superficial venous insufficiency.
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