Abstract：
BACKGROUND: Great saphenous vein diameter (GSV) of >8 mm was predictor of recanalization following Venaseal cyanoacrylate treatment. The aim of this study was to report our modified protocol with a single extra-drop for treatment for GSV>8 mm, and comparative duplex results in closure rates.
METHODS: Patients in our single-centre registry treated with Venaseal were followed up by serial duplex examinations at week 1 and month(s)- 1, 6, 12, 18, 24, and then annually. The primary endpoint was successful obliteration of the GSV, secondary endpoints were closure distance from Saphenofemoral junction (SFJ), presence of endovenous glue-induced thrombosis (EGIT) or deep vein thrombosis.
RESULTS: A total of 243 legs in 123 consecutive patients with duplex-proven SFJ/GSV incompetence were included in this study between September 2014 and October 2020. The median duplex follow-up period of this cohort of patients was 24 (range 0.2-58) months. Comparing closure rates in GSV diameter ≥8 mm treated with normal protocol, the \'extra-drop protocol\' significantly improved closure rates (p = .034). However, the closure rates of ≥8 mm GSV treated with \'extra-drop protocol\' was still not as good as GSV <8 mm (p < .001). There were no statistically significant differences in the stump distance between the three groups and no difference in the occurrence of EGIT. There were no deep vein thrombosis.
CONCLUSIONS: Our experience showed that VenaSeal cyanoacrylate worked best in GSV<8 mm diameter. Even in GSV diameter of ≥8 mm which has a higher recanalization rate on follow-up duplex, our modified extra-drop protocol significantly improved the closure rates, and did not predispose to development of EGIT.
METHODS: Patients in our single-centre registry treated with Venaseal were followed up by serial duplex examinations at week 1 and month(s)- 1, 6, 12, 18, 24, and then annually. The primary endpoint was successful obliteration of the GSV, secondary endpoints were closure distance from Saphenofemoral junction (SFJ), presence of endovenous glue-induced thrombosis (EGIT) or deep vein thrombosis.
RESULTS: A total of 243 legs in 123 consecutive patients with duplex-proven SFJ/GSV incompetence were included in this study between September 2014 and October 2020. The median duplex follow-up period of this cohort of patients was 24 (range 0.2-58) months. Comparing closure rates in GSV diameter ≥8 mm treated with normal protocol, the \'extra-drop protocol\' significantly improved closure rates (p = .034). However, the closure rates of ≥8 mm GSV treated with \'extra-drop protocol\' was still not as good as GSV <8 mm (p < .001). There were no statistically significant differences in the stump distance between the three groups and no difference in the occurrence of EGIT. There were no deep vein thrombosis.
CONCLUSIONS: Our experience showed that VenaSeal cyanoacrylate worked best in GSV<8 mm diameter. Even in GSV diameter of ≥8 mm which has a higher recanalization rate on follow-up duplex, our modified extra-drop protocol significantly improved the closure rates, and did not predispose to development of EGIT.
摘要：
背景：>8mm的大隐静脉直径（GSV）是经静脉氰基丙烯酸酯治疗后再通的预测因子。这项研究的目的是报告我们的修改方案，用单个额外的液滴治疗GSV>8毫米，和比较双工导致闭合率。
方法：我们的单中心登记处接受静脉治疗的患者在第1周和第1、6、12、18、24个月进行系列双工检查，然后每年进行一次。主要终点是成功消除GSV，次要终点是与股股线连接处（SFJ）的闭合距离，存在静脉内胶诱导的血栓形成（EGIT）或深静脉血栓形成。
结果：在2014年9月至2020年10月期间，共纳入123例经双重证实的SFJ/GSV功能不全的连续患者的243条腿。该队列患者的中位双重随访期为24个月（范围0.2-58个月）。比较正常方案治疗的GSV直径≥8mm的闭合率，“额外丢弃方案”显着提高了闭合率（p=.034）。然而,≥8mmGSV接受“额外滴注方案”治疗的闭合率仍不如GSV<8mm(p<.001).三组间残端距离差异无统计学意义,EGIT发生无差异。没有深静脉血栓形成。
结论：我们的经验表明，VenaSeal氰基丙烯酸酯在直径<8mm的GSV中效果最好。即使在GSV直径≥8mm的情况下，随访复通率也较高，我们修改的额外滴方案显著提高了闭合率，也不容易发展EGIT。
方法：我们的单中心登记处接受静脉治疗的患者在第1周和第1、6、12、18、24个月进行系列双工检查，然后每年进行一次。主要终点是成功消除GSV，次要终点是与股股线连接处（SFJ）的闭合距离，存在静脉内胶诱导的血栓形成（EGIT）或深静脉血栓形成。
结果：在2014年9月至2020年10月期间，共纳入123例经双重证实的SFJ/GSV功能不全的连续患者的243条腿。该队列患者的中位双重随访期为24个月（范围0.2-58个月）。比较正常方案治疗的GSV直径≥8mm的闭合率，“额外丢弃方案”显着提高了闭合率（p=.034）。然而,≥8mmGSV接受“额外滴注方案”治疗的闭合率仍不如GSV<8mm(p<.001).三组间残端距离差异无统计学意义,EGIT发生无差异。没有深静脉血栓形成。
结论：我们的经验表明，VenaSeal氰基丙烯酸酯在直径<8mm的GSV中效果最好。即使在GSV直径≥8mm的情况下，随访复通率也较高，我们修改的额外滴方案显著提高了闭合率，也不容易发展EGIT。
