Comparison of stripping/ligation and embolization with cyanoacrylate in venous insufficiency treatment

Abstract

Aim: Stripping/ligation (S/L) is the gold standard method used in the treatment of varicose veins. Saphenous vein ablation with cyanoacrylate (CA) is a new minimally invasive treatment method that forces this throne. Our aim is to compare these two methods in terms of patient satisfaction.
Methods: In this cross-sectional study, voluntary patients who had superficial venous insufficiency and varicose vein were divided into two groups as S/L and CA. CEAP (Clinical-Etiologic-Anatomic-Pathophysiologic-clinical score) and VAS (Visual Analogue Scale ) were evaluated on the 1st, 3rd, 7th, 14th, 30th postoperative days and at the outpatient follow-up visits 1 year later. SF-36 (Short Form-36) questionnaire was applied at the first month. VCSS (Venous Clinical Severity Score) of patients were compared at 6 months after surgery. Control, color doppler ultrasonography was performed on patients with recurrent varicose veins or those who were symptomatic. SPSS 22.0 program was used for data analysis.
Results: The preoperative and postoperative VCSS scores were lower in the CA group than in the S/L group (P<0.001). In both groups, postoperative VCSS score was lower compared to preoperative conditions (P<0.001). The VAS score of S/L group was higher than the CA group, during anesthesia, on the 1st, and 3rd postoperative days (P<0.001). However, during the procedure, on the 7th (P<0.001) and 14th days (P=0.033), VAS scores were lower in the S/L group than the CA group. In short form -36, viability score was better in the S/L group (P<0.001). CA group scored higher in the other parameters (such as physical functioning, role limitations, bodily pain, general mental health, social functioning, role limitations due to emotional problems and general health perceptions) (P˂0.001 for all).
Conclusion: Although the S/L method is the gold standard for varicose vein treatment, saphenous vein ablation with CA scored higher in terms of patient satisfaction.

Keywords

• Venous insufficiency,Stripping and ligation,Endovenous ablation with Cyanoacrylate,Short Form-36 quality of life questionnaire

Venöz yetmezlik ve varis tedavisinde stripping/ligasyon ve siyanoakrilat ile embolizasyon yöntemlerinin karşılaştırılması

Öz

Amaç: Sıyırma/ligasyon (S/L), varisli damarların tedavisinde kullanılan altın standart yöntemdir. Siyanoakrilat (CA) ile safen ven ablasyonu, bu tahtı zorlayan yeni minimal invaziv bir tedavi yöntemidir. Amacımız bu iki yöntemi hasta memnuniyeti noktasında karşılaştırmaktır.
Yöntemler: Bu makale kesitsel bir çalışma olarak tasarlandı. Gönüllü yüzeysel venöz yetmezliği ve varisi olan hastalar, S/L ve CA grubu şeklinde ikiye ayrıldı. CEAP (Klinik-Etiyolojik-Anatomik-Patofizyolojik-klinik skor) ve VAS (vizüel ağrı skalası) 1. gün, 3. gün, 7. gün, 14. gün, 30. gün ve poliklinik takip ziyaretlerinde 1 yıl sonra değerlendirildi. Bir ay sonra SF-36 (Kısa Form-36) anketi uygulandı. Hastaların ameliyat sonrasi 6. ayda VCSS (Venöz Klinik Şiddet Skor) karşılaştırıldı. Tekrarlayan varisli veya semptomatik hastalarda kontrol renkli doppler ultrasonografi yapıldı. Veri analizi için SPSS 22.0 programı kullanıldı.
Bulgular: CA grubunda ameliyat öncesi ve ameliyat sonrası VCSS, S/L grubuna göre anlamlı olarak düşüktü (P<0,001). S/L grubunun VAS skoru anestezi sırasında, 1. ve 3. günlerde CA grubundan daha yüksekti (P<0,001). Ancak işlem sırasında, 7. günde (P<0,001) ve 14. günde (P=0,033) VAS skoru S/L grubunda CA grubuna göre daha düşüktü. S/L grubunda Kısa Form-36 canlılık skoru anlamlı olarak daha iyi bulundu (P<0,001). Diğer parametrelerde (fiziksel işlevsellik, rol kısıtlamaları, bedensel ağrı, genel ruh sağlığı, sosyal işlevsellik, duygusal sorunlara bağlı rol kısıtlamaları ve genel sağlık algıları gibi) CA grubu üstündü (tümü için P<0,001).
Sonuç: Varis tedavisinde S/L yöntemi altın standart olmasına rağmen, CA ile safen ven ablasyonu hasta memnuniyeti açısından daha üstün bulunmuştur.

Anahtar Kelimeler

• Venöz yetmezlik,Sıyırma ve ligasyon,Siyanoakrilat ile endovenöz ablasyon,Kısa Form-36 yaşam kalitesi ölçeği

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