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

E.Thierjung, München

GLUE

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


Not: mutagenicpyrogenichemolyticsensitizingirritatingcytotoxic

N-BUTYL CYANOACRYLATE+BIOCOMPATIBLE ADDITIVES

ROD RAABE MD

INCREASED VISCOSITYRAPID POLYMERISATIONFLEXIBILITY



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

8 months HE 5x 24 months

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


8 months CD20 5x 24 months

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


8 months CD68 5x 24 months

METHOD


Endoluminal application of Cyanoacrylate to treat insufficient GSV and SSV


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?



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


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


-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


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



GLUE

STRIPPINGSCLEROTHERAPY

FOAM

INVAGINATING LASER

RFReconstructionCHIVA

Compression

PHLEBECTOMY

?GLUE

THANK YOUFOR LISTENING


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