Abstract：
Cyanoacrylate glue closure was first used in humans 10 years ago to treat venous reflux of the axial veins. Studies have since shown its clinical efficacy in vein closure. However, great need exists to elucidate further the types of specific adverse reactions that cyanoacrylate glue can cause for better patient selection and to minimize these events. In the present study, we systematically reviewed the literature to identify the types of reported reactions. In addition, we explored the pathophysiology contributing to these reactions and proposed the mechanistic pathway with inclusion of actual cases.
We searched the literature for reports of reactions following cyanoacrylate glue use in patients with venous diseases between 2012 and 2022. The search was performed using MeSH (medical subject headings) terms. The terms included cyanoacrylate, venous insufficiency, chronic venous disorder, varicose veins, vein varicosities, venous ulcer, venous wound, CEAP (clinical, etiologic, anatomic, pathophysiologic), vein, adverse events, phlebitis, hypersensitivity, foreign body granuloma, giant cell, endovenous glue-induced thrombosis, and allergy. The search was limited to the literature reported in English. These studies were evaluated for the type of product used and the reactions noted. A systematic review, in accordance with the PRISMA (preferred reporting items for systematic reviews and meta-analyses) method, was performed. Covidence software (Melbourne, VC, Australia) was used for full-text screening and data extraction. Two reviewers reviewed the data, and the content expert served as the tiebreaker.
We identified 102, of which, 37 reported on cyanoacrylate use other than in the context of chronic venous diseases and were excluded. Fifty-five reports were determined appropriate for data extraction. The adverse reactions to cyanoacrylate glue were phlebitis, hypersensitivity, foreign body granuloma, and endovenous glue-induced thrombosis.
Although cyanoacrylate glue closure for venous reflux is generally a safe and clinically effective treatment choice for patients with symptomatic chronic venous disease and axial reflux, some adverse events could be specific to the properties of the cyanoacrylate product. We propose mechanisms for how such reactions can occur based on histologic changes, published reports, and case examples; however, further exploration is necessary to confirm these theories.
We searched the literature for reports of reactions following cyanoacrylate glue use in patients with venous diseases between 2012 and 2022. The search was performed using MeSH (medical subject headings) terms. The terms included cyanoacrylate, venous insufficiency, chronic venous disorder, varicose veins, vein varicosities, venous ulcer, venous wound, CEAP (clinical, etiologic, anatomic, pathophysiologic), vein, adverse events, phlebitis, hypersensitivity, foreign body granuloma, giant cell, endovenous glue-induced thrombosis, and allergy. The search was limited to the literature reported in English. These studies were evaluated for the type of product used and the reactions noted. A systematic review, in accordance with the PRISMA (preferred reporting items for systematic reviews and meta-analyses) method, was performed. Covidence software (Melbourne, VC, Australia) was used for full-text screening and data extraction. Two reviewers reviewed the data, and the content expert served as the tiebreaker.
We identified 102, of which, 37 reported on cyanoacrylate use other than in the context of chronic venous diseases and were excluded. Fifty-five reports were determined appropriate for data extraction. The adverse reactions to cyanoacrylate glue were phlebitis, hypersensitivity, foreign body granuloma, and endovenous glue-induced thrombosis.
Although cyanoacrylate glue closure for venous reflux is generally a safe and clinically effective treatment choice for patients with symptomatic chronic venous disease and axial reflux, some adverse events could be specific to the properties of the cyanoacrylate product. We propose mechanisms for how such reactions can occur based on histologic changes, published reports, and case examples; however, further exploration is necessary to confirm these theories.
摘要：
目的：氰基丙烯酸酯胶封堵术在10年前首次应用于人体，用于治疗轴系静脉的静脉回流。此后的研究表明其在静脉闭合中的临床疗效。然而,有必要进一步阐明氰基丙烯酸酯胶可能导致的特定不良反应类型,以便更好地选择患者,并将这些事件降至最低.在本研究中,我们系统回顾了文献,以确定报告的反应类型.此外,我们探索了导致这些反应的病理生理学，并提出了包含实际病例的机制途径。
方法：我们检索了2012年至2022年间静脉疾病患者使用氰基丙烯酸酯胶后反应的文献。使用MeSH(医学主题标题)术语进行搜索。这些术语包括氰基丙烯酸酯，静脉功能不全,慢性静脉疾病，静脉曲张,静脉静脉曲张,静脉性溃疡,静脉伤口,CEAP(临床，病因学，解剖,病理生理学)，静脉,不良事件,静脉炎,超敏反应，异物肉芽肿,巨细胞,静脉内胶诱导的血栓形成，和过敏。搜索仅限于英文报道的文献。评估这些研究中所用产品的类型和所记录的反应。系统的审查，根据PRISMA(系统评价和荟萃分析的首选报告项目)方法，已执行。Covidence软件(墨尔本，VC,澳大利亚)用于全文筛选和数据提取。两名审查人员审查了数据，内容专家担任决胜局。
结果：我们确定了102个，其中，除慢性静脉疾病外，有37例报告了氰基丙烯酸酯的使用，被排除在外。确定了55份适合数据提取的报告。氰基丙烯酸酯胶的不良反应为静脉炎,超敏反应，异物肉芽肿,和静脉内胶诱导的血栓形成。
结论：尽管对于有症状的慢性静脉疾病和轴向反流的患者，氰基丙烯酸酯胶关闭静脉反流通常是一种安全且临床有效的治疗选择，一些不良事件可能与氰基丙烯酸酯产品的性质有关.我们提出了基于组织学变化的这种反应如何发生的机制，发表报告,和案例；然而，需要进一步的探索来证实这些理论。
方法：我们检索了2012年至2022年间静脉疾病患者使用氰基丙烯酸酯胶后反应的文献。使用MeSH(医学主题标题)术语进行搜索。这些术语包括氰基丙烯酸酯，静脉功能不全,慢性静脉疾病，静脉曲张,静脉静脉曲张,静脉性溃疡,静脉伤口,CEAP(临床，病因学，解剖,病理生理学)，静脉,不良事件,静脉炎,超敏反应，异物肉芽肿,巨细胞,静脉内胶诱导的血栓形成，和过敏。搜索仅限于英文报道的文献。评估这些研究中所用产品的类型和所记录的反应。系统的审查，根据PRISMA(系统评价和荟萃分析的首选报告项目)方法，已执行。Covidence软件(墨尔本，VC,澳大利亚)用于全文筛选和数据提取。两名审查人员审查了数据，内容专家担任决胜局。
结果：我们确定了102个，其中，除慢性静脉疾病外，有37例报告了氰基丙烯酸酯的使用，被排除在外。确定了55份适合数据提取的报告。氰基丙烯酸酯胶的不良反应为静脉炎,超敏反应，异物肉芽肿,和静脉内胶诱导的血栓形成。
结论：尽管对于有症状的慢性静脉疾病和轴向反流的患者，氰基丙烯酸酯胶关闭静脉反流通常是一种安全且临床有效的治疗选择，一些不良事件可能与氰基丙烯酸酯产品的性质有关.我们提出了基于组织学变化的这种反应如何发生的机制，发表报告,和案例；然而，需要进一步的探索来证实这些理论。
