cyanoacrylatklebung der vena saphena magnapast.mac-conference.com/xconfig/upload/files/$03-sa_e....

E.Thierjung, München

GLUE

E.Thierjung München

E.Thierjung, München

GLUE

STRIPPINGSCLEROTHERAPY

FOAM

INVAGINATING LASER

RFReconstructionCHIVA

Compression

PHLEBECTOMY

?

MEDTRONIC SHARES

Conflicts of interest

E.Thierjung, München Artemed Fachklinik

Use of Cyanoacrylate after FDA clearance 2000

Endovascular : intracerebral arteriovenous malformations

postendovascular graft leaks

Gastrointestinal bleeding and tumors

Genitourinary abnormalities

E.Thierjung, München

Not: mutagenicpyrogenichemolyticsensitizingirritatingcytotoxic

N-BUTYL CYANOACRYLATE+BIOCOMPATIBLE ADDITIVES

ROD RAABE MD

INCREASED VISCOSITYRAPID POLYMERISATIONFLEXIBILITY

E.Thierjung, München

E.Thierjung, München

E.Thierjung, München

Dr.med. B.Bier Institut für Pathologie Saarbrücken-Rastpful

8 months HE 5x 24 months

DR.MED. B.BIER INSTITUT FÜR PATHOLOGIE SAARBRÜCKEN-RASTPFUL

E.Thierjung, München

8 months CD20 5x 24 months

DR.MED. B.BIER INSTITUT FÜR PATHOLOGIE SAARBRÜCKEN-RASTPFUL

E.Thierjung, München

8 months CD68 5x 24 months

METHOD

E.Thierjung, München

Endoluminal application of Cyanoacrylate to treat insufficient GSV and SSV

E.Thierjung, München

E.Thierjung, München

E.Thierjung, München

BBBB

MethodLocal anesthetic: Mepivacainhydrochlorid 0,5%

Time frame: 30 months ( December 2012 – May 2015 )

Measurements: (after day 1, day 7, after 3, 12 and 24 months )stump length after treatmentdiameter of treated vein 2cm before SF-junctionultrasound check for reflux (directly after treatment and on follow-ups)need for compression therapy?

E.Thierjung, München

E.Thierjung, München

86 Pat

52J

Legs Length Diameter CEAP

GSV 127 47,65cm

(43-70)

0,68cm

(0,45-0,98)

C2-C4

SSV 16 16,4cm

(6-29)

0,52cm

(0,41-0,79)

C2-C4

E.Thierjung, München

GSV Day 0 1 Day 7 Day 3 Mo 12 Mon 24 Mo

Occlusion 0 100% 100% 100% 97,4%(79) 95,7%(47)

Stump

Distance 3,85cm

1,29cm 1,14cm 1,09cm 1,15cm 2,03cm

Diameter 0,68cm 0,50cm 0,48cm 0,45cm 0,39cm 0,35cm

Reflux

SF Junction

+ _ - - -

+ 2 x

-

+ 2 x

Results

VeClose Study 94,3 ( Roll-in phase 100%) 2YearsJ.Alm 100% 2YearsU.Zierau 97,75% 33 Month

Average amount of Cyanoacrylate: 1,47cc

Average dose of local anesthetic: 5,34cc

Intervention time : 18 min

Compression therapy: depending on CEAP:

0 days C2

3,7 days C3

10,2 days C4-5

E.Thierjung, München

-18 Patients with pain 3-4 out of 10 after 7 to 21 days( Erythema and lymphangitis ) on the thighNo such symptoms below the knee

- NSAID for 3-5 days

- No foreign body sensation along the treated area

E.Thierjung, München

E.Thierjung, München

Conclusions

• Technique easy to apply and quick

• Absorption in time

• Almost no anesthesia and compression

• Very quick recovery and high patient satisfaction

• Instant effect of the procedure

E.Thierjung, München

E.Thierjung, München

E.Thierjung, München

E.Thierjung, München

E.Thierjung, München

E.Thierjung, München

GLUE

STRIPPINGSCLEROTHERAPY

FOAM

INVAGINATING LASER

RFReconstructionCHIVA

Compression

PHLEBECTOMY

?GLUE

THANK YOUFOR LISTENING

E.Thierjung, München