The comparison of radiofrequency and Cyanoacrylate embolization therapy in vena saphena magna ablation.

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ER Z. C., Destan B., ÖZCAN S.



Abstract Aim: Chronic venous insufficiency is a frequent and disabling illness causing loss of life quality and labor. In this study, we aimed to compare the cyanoacrylate embolization and radiofrequency methods in vena saphena magna ablation therapy. Material and methods: Two hundred twenty patients with symptomatic venous insufficiency were involved in this study between November 2015 and January 2020 in Bozok University faculty of medicine cardiovascular surgery department. Patients were grouped into two groups. Group 1 included patients who were applied radiofrequency, and Group 2 included patients who underwent cyanoacrylate embolization. Preoperatively, Doppler ultrasound showed venous reflux and VSM diameter in all patients. Patient with non-tortuous veins and VSM diameter of more than 5.5 mm and a reflux duration of more than 0.5 seconds in the saphenofemoral junction were taken into consideration. This study included 110 cases in each group with similar demographic characteristics. After discharge, patients were called for control after one week, and in the first and sixth months they were evaluated with Doppler ultrasound. Results: A month later, during the procedure in Doppler USG control, we found o that VSM in 108 out of 110 patients (%98.18) was obliterated in the RF group. In the cyanoacrylate embolization (CAE) group, VSM was totally obliterated in all patients. Six months later, obliteration was 107 (%97.27) in RF and 109 (%99.09) in the cyanoacrylate group. In a month, %8.18 ecchymosis, %0.9 cellulitis and %1.81 thrombophlebitis were seen in the RF group. Complications in the cyanoacrylate group were ecchymosis in %10.9, cellulitis in %2.72 and trombophlebitis in %0.9. The duration of the procedure was 32.14 minutes in the RF group and 15.32 minutes in the CAE group. Preoperatively, the patients were asked 8 questions about the symptoms. After six months, the same questions were asked and answers were compared with the previous ones. In both groups, the recovery was similar. Discussion: Although the classical surgical procedure of venous insufficiency is a successful method, it has complications. When deciding the therapy method, cosmetic results should be kept in mind. Also, the short operation duration affects the choice. Frequently applied methods are EVLA, RFA, foam sclerotherapy, and CAE. RF and CAE technics were effective as classical surgery in chronic venous insufficiency. Effectiveness and complication rates were not different, but the shorter duration of procedure makes CAE more advantageous. Keywords Radiofrequency ablation; N-Butyl Cyanoacrylate; Embolization; Venous insufficiency