|
|
氰基丙烯酸酯胶治疗下肢静脉曲张的研究现状
|
Abstract:
下肢静脉曲张是血管外科常见疾病之一。手术是下肢静脉曲张的常用治疗手段，主要分为传统结扎剥脱术及微创腔内治疗技术。腔内热消融(Endovenous Thermal Ablation, EVTA)已逐步发展为一线治疗选择，但存在手术时间长、需要肿胀麻醉、热损伤相关并发症等问题。近十年以来兴起的氰基丙烯酸酯胶消融(Cyanoacrylate-glue Ablation, CAA)治疗下肢静脉曲张具有微创便捷、非热非肿胀、并发症发生率低、中远期闭合率高等优势，未来有望成为主流选择。本文就氰基丙烯酸酯胶(Cyanoacrylate Glue, CG)的发展、作用原理、疗效以及应用特点等方面进行综述。
Lower extremity varicose veins are one of the common diseases in vascular surgery. Surgery is a common treatment, mainly categorized into traditional ligation-stripping and minimally invasive endovenous techniques. Endovenous thermal ablation (EVTA) has gradually developed into a first-line treatment option, but there are some problems, such as long operation time, need for tumescent anaesthesia and thermal injury related complications. In the last decade, Cyanoacrylate-glue Ablation (CAA) has emerged as a treatment choice for lower extremity varicose veins. CAA has the advantages of minimally invasive and convenient, non-thermal and non-tumescent, low incidence of complications, high medium and long-term closure rate, and is expected to become the mainstream choice in the future. This paper reviews the development, principles, curative effect and application characteristics of Cyanoacrylate Glue (CG).
| [1] | 中华医学会外科学分会血管外科学组, 中国医师协会血管外科医师分会, 中国医疗保健国际交流促进会血管外科分会, 等. 中国慢性静脉疾病诊断与治疗指南[J]. 中华医学杂志, 2019, 99(39): 3047-3061. |
| [2] | Gloviczki, P., Lawrence, P.F., Wasan, S.M., Meissner, M.H., Almeida, J., Brown, K.R., et al. (2024) The 2023 Society for Vascular Surgery, American Venous Forum, and American Vein and Lymphatic Society Clinical Practice Guidelines for the Management of Varicose Veins of the Lower Extremities. Part II: Endorsed by the Society of Interventional Ra-diology and the Society for Vascular Medicine. Journal of Vascular Surgery: Venous and Lymphatic Disorders, 12, Article ID: 101670. https://doi.org/10.1016/j.jvsv.2023.08.011 |
| [3] | Singer, A.J., Quinn, J.V. and Hollander, J.E. (2008) The Cyanoacrylate Topical Skin Adhesives. The American Journal of Emergency Medicine, 26, 490-496. https://doi.org/10.1016/j.ajem.2007.05.015 |
| [4] | Ronis, M.L., Harwich, J.D., Fung, R. and Dellavecchia, M. (1984) Review of Cyanoacrylate Tissue Glues with Emphasis on Their Otorhinolaryngological Applications. The Laryngoscope, 94, 210-213. https://doi.org/10.1288/00005537-198402000-00012 |
| [5] | Almeida, J.I., Min, R.J., Raabe, R., McLean, D.J. and Madsen, M. (2011) Cyanoacrylate Adhesive for the Closure of Truncal Veins: 60-Day Swine Model Results. Vascular and Endovascular Surgery, 45, 631-635. https://doi.org/10.1177/1538574411413938 |
| [6] | Almeida, J.I., Javier, J.J., Mackay, E., Bautista, C. and Proebstle, T.M. (2013) First Human Use of Cyanoacrylate Adhesive for Treatment of Saphenous Vein Incompetence. Journal of Vascular Surgery: Venous and Lymphatic Disorders, 1, 174-180. https://doi.org/10.1016/j.jvsv.2012.09.010 |
| [7] | Proebstle, T.M., Alm, J., Dimitri, S., Rasmussen, L., Whiteley, M., Lawson, J., et al. (2015) The European Multicenter Cohort Study on Cyanoacrylate Embolization of Refluxing Great Saphenous Veins. Journal of Vascular Surgery: Venous and Lymphatic Disorders, 3, 2-7. https://doi.org/10.1016/j.jvsv.2014.09.001 |
| [8] | Morrison, N., Gibson, K., McEnroe, S., Goldman, M., King, T., Weiss, R., et al. (2015) Randomized Trial Comparing Cyanoacrylate Embolization and Radiofrequency Ablation for Incompetent Great Saphenous Veins (VeClose). Journal of Vascular Surgery, 61, 985-994. https://doi.org/10.1016/j.jvs.2014.11.071 |
| [9] | Yavuz, T., Acar, A.N., Aydın, H. and Ekingen, E. (2018) A Retrospective Study of a New n-Butyl-2-Cyanoacrylate Glue Ablation Catheter Incorporated with Application Guiding Light for the Treatment of Venous Insufficiency: Twelve-Month Results. Vascular, 26, 547-555. https://doi.org/10.1177/1708538118770548 |
| [10] | Bissacco, D., Stegher, S., Calliari, F.M. and Viani, M.P. (2018) Saphenous Vein Ablation with a New Cyanoacrylate Glue Device: A Systematic Review on 1000 Cases. Minimally Invasive Therapy & Allied Technologies, 28, 6-14. https://doi.org/10.1080/13645706.2018.1464029 |
| [11] | Sarac, A. (2019) RETRACTED: Two-Year Follow-Up of a N-Butyl-2-Cyanoacrylate Glue Ablation for the Treatment of Saphenous Vein Insufficiency with a Novel Application Catheter with Guiding Light. Vascular, 27, 352-358. https://doi.org/10.1177/1708538118823838 |
| [12] | De Maeseneer, M.G., Kakkos, S.K., Aherne, T., Baekgaard, N., Black, S., Blomgren, L., et al. (2022) Editor’s Choice—European Society for Vascular Surgery (ESVS) 2022 Clinical Practice Guidelines on the Management of Chronic Venous Disease of the Lower Limbs. European Journal of Vascular and Endovascular Surgery, 63, 184-267. https://doi.org/10.1016/j.ejvs.2021.12.024 |
| [13] | Eroglu, E. and Yasim, A. (2018) A Randomised Clinical Trial Comparing N-Butyl Cyanoacrylate, Radiofrequency Ablation and Endovenous Laser Ablation for the Treatment of Superficial Venous Incompetence: Two Year Follow up Results. European Journal of Vascular and Endovascular Surgery, 56, 553-560. https://doi.org/10.1016/j.ejvs.2018.05.028 |
| [14] | Morrison, N., Gibson, K., Vasquez, M., Weiss, R. and Jones, A. (2020) Five-year Extension Study of Patients from a Randomized Clinical Trial (VeClose) Comparing Cyanoacrylate Closure versus Radiofrequency Ablation for the Treatment of Incompetent Great Saphenous Veins. Journal of Vascular Surgery: Venous and Lymphatic Disorders, 8, 978-989. https://doi.org/10.1016/j.jvsv.2019.12.080 |
| [15] | Joh, J.H., Lee, T., Byun, S.J., Cho, S., Park, H.S., Yun, W., et al. (2022) A Multicenter Randomized Controlled Trial of Cyanoacrylate Closure and Surgical Stripping for Incompetent Great Saphenous Veins. Journal of Vascular Surgery: Venous and Lymphatic Disorders, 10, 353-359. https://doi.org/10.1016/j.jvsv.2021.08.012 |
| [16] | García-Carpintero, E., Carmona, M., Chalco-Orrego, J.P., González-Enríquez, J. and Imaz-Iglesia, I. (2020) Systematic Review and Meta-Analysis of Endovenous Cyanoacrylate Adhesive Ablation for Incompetent Saphenous Veins. Journal of Vascular Surgery: Venous and Lymphatic Disorders, 8, 287-296. https://doi.org/10.1016/j.jvsv.2019.09.010 |
| [17] | Tang, T.Y., Yap, C.J.Q., Chan, S.L., Soon, S.X.Y., Yap, H.Y., Lee, S.Q.W., et al. (2021) Early Results of an Asian Prospective Multicenter Venaseal Real-World Postmarket Evaluation to Investigate the Efficacy and Safety of Cyanoacrylate Endovenous Ablation for Varicose Veins. Journal of Vascular Surgery: Venous and Lymphatic Disorders, 9, 335-345.e2. https://doi.org/10.1016/j.jvsv.2020.03.020 |
| [18] | Proebstle, T., Alm, J., Dimitri, S., Rasmussen, L., Whiteley, M., Lawson, J., et al. (2021) Three-year Follow-Up Results of the Prospective European Multicenter Cohort Study on Cyanoacrylate Embolization for Treatment of Refluxing Great Saphenous Veins. Journal of Vascular Surgery: Venous and Lymphatic Disorders, 9, 329-334. https://doi.org/10.1016/j.jvsv.2020.05.019 |
| [19] | Parsi, K., Zhang, L., Whiteley, M.S., Vuong, S., Kang, M., Naidu, N., et al. (2023) 899 Serious Adverse Events Including 13 Deaths, 7 Strokes, 211 Thromboembolic Events, and 482 Immune Reactions: The Untold Story of Cyanoacrylate Adhesive Closure. Phlebology: The Journal of Venous Disease, 39, 80-95. https://doi.org/10.1177/02683555231211086 |
| [20] | Imai, T., Mo, M., Hirokawa, M., Kurihara, N., Shokoku, S., Sugiyama, S., et al. (2024) Mid-term Results of Cyanoacrylate Closure for the Treatment of Incompetent Great and Small Saphenous Veins: Findings from a Japanese Prospective Consecutive Multi-Center Registry: Mid-Term Results of Cyanoacrylate Closure. Phlebology: The Journal of Venous Disease, 40, 21-28. https://doi.org/10.1177/02683555241273013 |
| [21] | Cho, S. and Joh, J.H. (2021) Cyanoacrylate Closure of Small Saphenous Vein Insufficiency. Dermatologic Surgery, 47, 381-384. https://doi.org/10.1097/dss.0000000000002748 |
| [22] | Giannopoulos, S., Rodriguez, L., Chau, M., Rodrigues, D., Labropoulos, N., Aziz, F., et al. (2022) A Systematic Review of the Outcomes of Percutaneous Treatment Modalities for Pathologic Saphenous and Perforating Veins. Journal of Vascular Surgery: Venous and Lymphatic Disorders, 10, 1172-1183.e5. https://doi.org/10.1016/j.jvsv.2022.03.005 |
| [23] | Prasad BP, K., Joy, B., Toms, A. and Sleeba, T. (2017) Treatment of Incompetent Perforators in Recurrent Venous Insufficiency with Adhesive Embolization and Sclerotherapy. Phlebology: The Journal of Venous Disease, 33, 242-250. https://doi.org/10.1177/0268355517696612 |
| [24] | Türkmen, U. (2024) Single-center Clinical Experience of Cyanoacrylate Embolization Method for Incompetent Perforating Veins in Treating CEAP-6 Patients. Journal of Vascular Surgery: Venous and Lymphatic Disorders, 12, Article ID: 101939. https://doi.org/10.1016/j.jvsv.2024.101939 |
| [25] | Chan, Y.C., Law, Y., Cheung, G.C., Ting, A.C. and Cheng, S.W. (2016) Cyanoacrylate Glue Used to Treat Great Saphenous Reflux: Measures of Outcome. Phlebology: The Journal of Venous Disease, 32, 99-106. https://doi.org/10.1177/0268355516638200 |
| [26] | Lee, C. (2023) The Novel Surgical Technique in the Cyanoacrylate Closure for Incompetent Great Saphenous Veins. Vascular and Endovascular Surgery, 58, 486-490. https://doi.org/10.1177/15385744231225910 |
| [27] | Falvo, N., Latreche, A., Chevallier, O., Ledan, F., Jandot, M., Daoud, H., et al. (2023) Cyanoacrylate Glue for Treating Chronic Saphenous Vein Insufficiency: A Retrospective Observational Single-Center Study. Diagnostics, 13, Article 2313. https://doi.org/10.3390/diagnostics13142313 |
| [28] | Chan, Y.C., Cheung, G.C., Ting, A.C. and Cheng, S.W. (2022) Modification of Protocol with One Extra Drop of Endovascular Cyanoacrylate Improved Closure Rates in Incompetent Great Saphenous Veins. Phlebology: The Journal of Venous Disease, 37, 425-431. https://doi.org/10.1177/02683555221082358 |
| [29] | Chan, Y.C., Law, Y., Cheung, G.C. and Cheng, S.W. (2017) Predictors of Recanalization for Incompetent Great Saphenous Veins Treated with Cyanoacrylate Glue. Journal of Vascular and Interventional Radiology, 28, 665-671. https://doi.org/10.1016/j.jvir.2017.01.011 |
