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A new application of external valvuloplasty using interventional injection of N-butyl cyanoacrylate for malfunctioning venous valves

Year 2020, Volume: 4 Issue: 9, 775 - 778, 01.09.2020
https://doi.org/10.28982/josam.796153

Abstract

Aim: Chronic venous insufficiency (CVI) is a common disorder that occurs when the venous valves are not working sufficiently. The treatment strategies depend on ameliorating the function of the valves. The aim of this study was to evaluate the external application of N-Butyl Cyanoacrylate to improve venous valves’ functions.
Methods: Thirty patients with CVI who were admitted to the cardiovascular surgery clinic with CVI complaints and underwent extravenous N-Butyl Cyanoacrylate application (extravenous application to the area surrounding the malfunctioning venous valves) between January 2020 and June 2020 were included in this retrospective cohort study. Preoperative and postoperative (third and sixth month) venous Doppler ultrasound findings and complaints were noted, and the results were compared.
Results: The diameter of the great saphenous vein was found to have decreased during the postoperative period (9.27 (1.95 mm) vs. 6.27 (2.16), P=0.001). Decremental saphenofemoral reflux durations were detected in postoperative ultrasound evaluations when compared with preoperative data (0.77(0.87) vs. 4.77(0.97) seconds). CVI complaints, including oedema, pigmentation and restless leg syndrome, improved within months after the operation.
Conclusion: The external application of N-Butyl Cyanoacrylate gel seems effective for recovering venous valve function in the medium term.

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References

  • 1. Sándor T. Chronic venous disease. A state of art. Orv Hetil. 2010;151:131-9.
  • 2. Ross DS. Venous stasis ulcers: a review. Northeast Florida Medicine. 2012;63:29-51.
  • 3. Eberhardt RT, Raffetto JD. Chronic venous insufficiency. Circulation. 2005;111:2398-409.
  • 4. Santler B, Goerge T. Chronic venous insufficiency - a review of pathophysiology, diagnosis, and treatment. J Dtsch Dermatol Ges. 2017;15(5):538-56. doi: 10.1111/ddg.13242
  • 5. van Gent WB, Catarinella FS, Lam YL, Nieman FH, Toonder IM, van der Ham AC, et al. Conservative versus surgical treatment of venous leg ulcers: 10-year follow up of a randomized, multicenter trial. Phlebology. 2015;30(1 Suppl):35-41. doi: 10.1177/0268355514568848
  • 6. Derin Çiçek E, Arslan HM. The efficacy of external valvuloplasty with silicone stents (Venocuff™) in the management of focal valvular incompetence as assessed by Doppler ultrasound. Turk J Vasc Surg. 2020;29(3):152-8.
  • 7. Lane RJ, Cuzzilla ML, Coroneos JC, Phillips MN, Platt JT. Recurrence rates following external valvular stenting of the saphenofemoral junction: a comparison with simultaneous contralateral stripping of the great saphenous vein. Eur J Vasc Endovasc Surg. 2007;34(5):595-604. doi:10.1016/j.ejvs.2007.06.021
  • 8. Lane RJ, Graiche JA, Coroneos JC, Cuzzilla ML. Long-term comparison of external valvular stenting and stripping of varicose veins. ANZ J Surg. 2003;73(8):605-9. doi:10.1046/j.1445-2197.2003.02714.x
  • 9. Karahan O, Yavuz C, Kankilic N, Demirtas S, Tezcan O, Caliskan A, et al. Simple blood tests as predictive markers of disease severity and clinical condition in patients with venous insufficiency. Blood Coagul Fibrinolysis. 2016;27(6):684-90. doi:10.1097/MBC.0000000000000478
  • 10. Song IK, Kim EH, Lee JH, Jang YE, Kim HS, Kim JT. Seldinger vs modified Seldinger techniques for ultrasound-guided central venous catheterisation in neonates: a randomised controlled trial. Br J Anaesth. 2018;121(6):1332-7. doi:10.1016/j.bja.2018.08.008
  • 11. Yavuz C, Demirtas S, Guclu O, Karahan O, Yazici S, Caliskan A, et al. An alternative therapy for recurrent stasis ulcers in chronic venous insufficiency: venocuff. Case Rep Vasc Med. 2012;2012:315147. doi:10.1155/2012/315147
  • 12. Goel RR, Abidia A, Hardy SC. Surgery for deep venous incompetence. Cochrane Database Syst Rev. 2015;2015(2):CD001097.
  • 13. Hardy SC, Riding G, Abidia A. Surgery for deep venous incompetence. Cochrane Database Syst Rev. 2004;(3):CD001097. doi:10.1002/14651858.CD001097.pub2
  • 14. Joh JH, Lee KB, Yun WS, Lee BB, Kim YW, Kim DI. External banding valvuloplasty for incompetence of the great saphenous vein: 10-year results. International Journal of Angiology. 2009;18(1):25–8.
  • 15. Sarac A, Jahollari A, Talay S, Ozkaya S, Ozal E. Long-term results of external valvuloplasty in adult patients with isolated great saphenous vein insufficiency. Clin Interv Aging. 2014;9:575-9. doi:10.2147/CIA.S60555
  • 16. Zamboni P, Marcellino MG, Cappelli M, Feo CV, Bresadola V, Vasquez G, et al. Saphenous vein sparing surgery: principles, techniques and results. J Cardiovasc Surg (Torino) 1998;39:151-62.
  • 17. Ragg JC: A New Modality to Shape Enlarged Veins and Restore Valves by Perivenous Injection of Viscous Fluids. J Am Coll Cardiol Intv 2014;7:S33.

Venöz kapak yetmezliği için N-butil siyanoakrilatın girişimsel enjeksiyonunu kullanan yeni bir harici valvüloplasti uygulaması

Year 2020, Volume: 4 Issue: 9, 775 - 778, 01.09.2020
https://doi.org/10.28982/josam.796153

Abstract

Amaç: Kronik venöz yetmezlik (CVI), venöz kapaklar yeterince çalışmadığında ortaya çıkan yaygın bir hastalıktır. Bu nedenle tedavi stratejileri, kapakların fonksiyonlarının iyileştirilmesine dayanır. Bu çalışmada, venöz kapak fonksiyonlarını iyileştirmek için N-Butil Siyanoakrilat'ın harici uygulamasını değerlendirmeyi amaçladık.
Yöntemler: Ocak 2020-Haziran 2020 tarihleri arasında kardiyovasküler cerrahi kliniğine CVI şikayetleri ile başvuran hastalar geriye dönük olarak kayıt altına alındı. Ekstravenöz N-Butil Siyanoakrilat uygulaması yapılan 30 hasta (fonksiyonu bozulmuş venöz kapak çevresini sarma olarak ekstravenöz uygulama) çalışmaya dahil edildi. Preoperatif ve postoperatif (3. ve 6. ay) venöz Doppler ultrason bulguları ve şikayetleri not edildi ve sonuçlar karşılaştırıldı.
Bulgular: Büyük safen ven çapı postoperatif dönemde geriledi (9,27 (1,95 mm) ve. 6,27 (2,16), P=0,001). Preoperatif verilerle karşılaştırıldığında, postoperatif ultrason değerlendirmelerinde azalan safenofemoral reflü süreleri saptandı (0,77 (0,87) ve 4,77 (0,97) saniye). Operasyondan aylar sonra ödem, pigmentasyon, bacakta huzursuzluk vb. şikayetler geriledi.
Sonuç: Sonuçlarımız, N-Butil Siyanoakrilat jelin harici uygulamasının orta vadede venöz kapak fonksiyonlarının iyileştirilmesinde etkili olduğunu gösterdi.

Project Number

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References

  • 1. Sándor T. Chronic venous disease. A state of art. Orv Hetil. 2010;151:131-9.
  • 2. Ross DS. Venous stasis ulcers: a review. Northeast Florida Medicine. 2012;63:29-51.
  • 3. Eberhardt RT, Raffetto JD. Chronic venous insufficiency. Circulation. 2005;111:2398-409.
  • 4. Santler B, Goerge T. Chronic venous insufficiency - a review of pathophysiology, diagnosis, and treatment. J Dtsch Dermatol Ges. 2017;15(5):538-56. doi: 10.1111/ddg.13242
  • 5. van Gent WB, Catarinella FS, Lam YL, Nieman FH, Toonder IM, van der Ham AC, et al. Conservative versus surgical treatment of venous leg ulcers: 10-year follow up of a randomized, multicenter trial. Phlebology. 2015;30(1 Suppl):35-41. doi: 10.1177/0268355514568848
  • 6. Derin Çiçek E, Arslan HM. The efficacy of external valvuloplasty with silicone stents (Venocuff™) in the management of focal valvular incompetence as assessed by Doppler ultrasound. Turk J Vasc Surg. 2020;29(3):152-8.
  • 7. Lane RJ, Cuzzilla ML, Coroneos JC, Phillips MN, Platt JT. Recurrence rates following external valvular stenting of the saphenofemoral junction: a comparison with simultaneous contralateral stripping of the great saphenous vein. Eur J Vasc Endovasc Surg. 2007;34(5):595-604. doi:10.1016/j.ejvs.2007.06.021
  • 8. Lane RJ, Graiche JA, Coroneos JC, Cuzzilla ML. Long-term comparison of external valvular stenting and stripping of varicose veins. ANZ J Surg. 2003;73(8):605-9. doi:10.1046/j.1445-2197.2003.02714.x
  • 9. Karahan O, Yavuz C, Kankilic N, Demirtas S, Tezcan O, Caliskan A, et al. Simple blood tests as predictive markers of disease severity and clinical condition in patients with venous insufficiency. Blood Coagul Fibrinolysis. 2016;27(6):684-90. doi:10.1097/MBC.0000000000000478
  • 10. Song IK, Kim EH, Lee JH, Jang YE, Kim HS, Kim JT. Seldinger vs modified Seldinger techniques for ultrasound-guided central venous catheterisation in neonates: a randomised controlled trial. Br J Anaesth. 2018;121(6):1332-7. doi:10.1016/j.bja.2018.08.008
  • 11. Yavuz C, Demirtas S, Guclu O, Karahan O, Yazici S, Caliskan A, et al. An alternative therapy for recurrent stasis ulcers in chronic venous insufficiency: venocuff. Case Rep Vasc Med. 2012;2012:315147. doi:10.1155/2012/315147
  • 12. Goel RR, Abidia A, Hardy SC. Surgery for deep venous incompetence. Cochrane Database Syst Rev. 2015;2015(2):CD001097.
  • 13. Hardy SC, Riding G, Abidia A. Surgery for deep venous incompetence. Cochrane Database Syst Rev. 2004;(3):CD001097. doi:10.1002/14651858.CD001097.pub2
  • 14. Joh JH, Lee KB, Yun WS, Lee BB, Kim YW, Kim DI. External banding valvuloplasty for incompetence of the great saphenous vein: 10-year results. International Journal of Angiology. 2009;18(1):25–8.
  • 15. Sarac A, Jahollari A, Talay S, Ozkaya S, Ozal E. Long-term results of external valvuloplasty in adult patients with isolated great saphenous vein insufficiency. Clin Interv Aging. 2014;9:575-9. doi:10.2147/CIA.S60555
  • 16. Zamboni P, Marcellino MG, Cappelli M, Feo CV, Bresadola V, Vasquez G, et al. Saphenous vein sparing surgery: principles, techniques and results. J Cardiovasc Surg (Torino) 1998;39:151-62.
  • 17. Ragg JC: A New Modality to Shape Enlarged Veins and Restore Valves by Perivenous Injection of Viscous Fluids. J Am Coll Cardiol Intv 2014;7:S33.
There are 17 citations in total.

Details

Primary Language English
Subjects Surgery
Journal Section Research article
Authors

Erhan Hafız 0000-0002-0801-3194

Elzem Sen This is me 0000-0003-3001-7324

Project Number -
Publication Date September 1, 2020
Published in Issue Year 2020 Volume: 4 Issue: 9

Cite

APA Hafız, E., & Sen, E. (2020). A new application of external valvuloplasty using interventional injection of N-butyl cyanoacrylate for malfunctioning venous valves. Journal of Surgery and Medicine, 4(9), 775-778. https://doi.org/10.28982/josam.796153
AMA Hafız E, Sen E. A new application of external valvuloplasty using interventional injection of N-butyl cyanoacrylate for malfunctioning venous valves. J Surg Med. September 2020;4(9):775-778. doi:10.28982/josam.796153
Chicago Hafız, Erhan, and Elzem Sen. “A New Application of External Valvuloplasty Using Interventional Injection of N-Butyl Cyanoacrylate for Malfunctioning Venous Valves”. Journal of Surgery and Medicine 4, no. 9 (September 2020): 775-78. https://doi.org/10.28982/josam.796153.
EndNote Hafız E, Sen E (September 1, 2020) A new application of external valvuloplasty using interventional injection of N-butyl cyanoacrylate for malfunctioning venous valves. Journal of Surgery and Medicine 4 9 775–778.
IEEE E. Hafız and E. Sen, “A new application of external valvuloplasty using interventional injection of N-butyl cyanoacrylate for malfunctioning venous valves”, J Surg Med, vol. 4, no. 9, pp. 775–778, 2020, doi: 10.28982/josam.796153.
ISNAD Hafız, Erhan - Sen, Elzem. “A New Application of External Valvuloplasty Using Interventional Injection of N-Butyl Cyanoacrylate for Malfunctioning Venous Valves”. Journal of Surgery and Medicine 4/9 (September 2020), 775-778. https://doi.org/10.28982/josam.796153.
JAMA Hafız E, Sen E. A new application of external valvuloplasty using interventional injection of N-butyl cyanoacrylate for malfunctioning venous valves. J Surg Med. 2020;4:775–778.
MLA Hafız, Erhan and Elzem Sen. “A New Application of External Valvuloplasty Using Interventional Injection of N-Butyl Cyanoacrylate for Malfunctioning Venous Valves”. Journal of Surgery and Medicine, vol. 4, no. 9, 2020, pp. 775-8, doi:10.28982/josam.796153.
Vancouver Hafız E, Sen E. A new application of external valvuloplasty using interventional injection of N-butyl cyanoacrylate for malfunctioning venous valves. J Surg Med. 2020;4(9):775-8.