Audit of the efficacy and complications of cyanoacrylate glue embolisation to treat varicose veins in primary care

Abstract

ABSTRACT INTRODUCTIONCyanoacrylate glue embolization (CAGE) is a non-surgical procedure that uses a proprietary medical adhesive, delivered endovenously to close truncal, varicose veins. AIMTo describe CAGE administered by a New Zealand general practitioner (GP) in primary care. METHODSThe procedures were performed by a single GP with a special interest and 19 years’ clinical experience in procedural phlebology. The clinical records of 107 consecutive patients who underwent CAGE over a 2-year period were retrospectively reviewed. Some patients had bilateral disease and some had more than one truncal vein per leg treated. Data on 173 truncal veins were included in the audit. Clinical data, procedural details and postprocedural course were recorded and analysed for 71 females and 36 males. RESULTSIn total, 173 truncal veins were treated. They included the anterior accessory saphenous vein, the great saphenous vein, the small (lesser) saphenous vein and the thigh extension with a range of clinical severity. The most commonly treated truncal vein was the great saphenous vein with an average truncal diameter of 8.8mm (2.9s.d.). Of the 173 treated truncal veins, two failed to seal with CAGE, but were sealed after adjuvant ultrasound-guided foam sclerotherapy treatment. Post CAGE, 14.5% of treated truncal veins developed a phlebitis. DISCUSSIONThis audit shows that varicose veins can be treated in general practice with high levels of anatomic efficacy and few adverse effects.