Introduction

This is a retrospective analysis of the results of treatment for large varicose veins using the sandwich technique with cyanoacrylate glue and foam sclerotherapy. This hybrid method is more effective in comparison with standard foam sclerotherapy, and also allows for substantial reduction of the amount of glue needed for the vein closure.

Material and methods

This technique was used in 17 patients presenting with incompetent saphenous veins which were ≥ 15 mm in diameter. 13 incompetent great saphenous veins and 4 anterior accessory saphenous veins were managed. The glue was administered in small drops, 0.1–0.2 ml each, under ultrasound control, through direct percutaneous punctures of the target veins. The volume of injected glue was 0.8–1.0 ml. Remaining unclosed segments of the target vein and epifascial varicosities were managed with foam sclerotherapy. Follow-up visits were scheduled 2–3 weeks after the procedure. If revealed, unclosed segments of the target veins were obliterated at these follow-up visits, with glue and/or sclerotherapy.

Results

There were no intra- or postprocedural serious adverse events. The technical success rate was 100%. The primary success rate at a 2–3 week follow-up visit was 88.2%. The primary assisted success rate, after additional closures, was 100%.

Conclusions

The treatment for varicose veins, using the sandwich technique, which combines cyanoacrylate glue and foam sclerotherapy, can be safe and efficient, even if the varicosities are large.