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