Introduction

The article presents an evaluation of the effectiveness of incompetent perforating vein (IPV) closure in the lower limbs using chemical ablation with cyanoacrylate glue (n-butyl-2-cyanoacrylate). The aim of the study was to assess the efficacy and safety of this minimally invasive treatment technique. Incompetent perforating veins play a major role in the development of a dangerous complication of chronic venous insufficiency – venous ulcer. Incompetent perforating veins are one of the most common cause of recurrent varicose veins after surgical treatment, which results in the progression of chronic vein disease.

Material and methods

The study was conducted at JBS Phlebology Clinic in Gdansk and Lublin. Among 2,500 patients with chronic venous diseases, 120 patients with 132 isolated IVP were qualified for treatment. The procedure consisted of percutaneous administration of cyanoacrylate glue under Doppler ultrasound guidance. Clinical and ultrasound follow-up examinations were performed after 4 and 8 weeks.

Results

The results were divided into two groups:
1. Complete closure – good result – 115 (87%) IPV;
2. Narrowing without reflux – satisfactory result – 17 (13%) IPV.
The lowest efficacy was observed in posterior tibial IPV (76.2%), and the highest in just above the knee (medial knee – 100%) and thigh IPV (medial thigh, posterior thigh – 100%). No recanalisation of successfully closed veins was observed during follow-up. Complications were minor and included transient burning sensation and discomfort at the injection site.

Conclusions

The authors conclude that chemical ablation with cyanoacrylate glue is an effective, safe and promising outpatient treatment method for incompetent perforating veins which does not require post-procedural compression therapy.