Perivascular Administration of Hyaluran-Cyanoacrylate Complex Gel for Deep Venous Reflux

Abstract

Objective: Deep venous insufficiency is an important health issue affecting the population worldwide. In this study we aimed to assess the effectiveness and safety of a novel antireflux treatment procedure in patients with primary deep vein insufficiency. Methods: Between October 2016 and December 2018, 81 valvular leak operations consisting of perivenous hard gel injection were performed in 81 patients with primary deep venous insufficiency. The clinical symptoms of the patients were between C3-C6 according to the CEAP clinical classification. Venous insufficiency associated with only one deep venous valve was verified with Doppler ultrasonography. Patients were assessed with physical and ultrasound examination on the follow-up visits, which were achieved on the third day and at the first, sixth, and twelfth months. The nonexistence of reflux in the treated valve level was defined as the success of the procedure. Any reflux, which lasted 0.5 seconds or more, was regarded as a lack of success. Results: The ages of the patients ranged between 32 and 78. All the patients had deep venous insufficiency. The follow-up could be achieved in all the patients. The mean volume of the gel administered was 2.4±0.9 ml. The mean procedure duration was 22.3±8.9 (range 14–42) minutes. The procedures could be performed successfully in all of the patients confirmed perioperatively and on the third day of follow-up with the elimination of reflux. The sixth-month follow-up, with the same vein diameter after the treatment without any reflux, revealed the same findings as to the first-month follow-up. The treatment was not associated with any significant morbidity or mortality. The VCSS decreased significantly when preprocedural and twelfth-month VCSS were compared as 21.8 ± 4.8 and 3.8±0.7, respectively (p