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Updated: Oct 25, 2025
08:05
Occlusion of the Great and Small Saphenous Vein Using Copolymeric Glue Based on N-Butyl Cyanoacrylate and Methacryloxy Sulfolane
Published on: December 9, 2022
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Interventions for great saphenous vein incompetence
Jade Whing1, Sandip Nandhra1, Craig Nesbitt1
1Northern Vascular Centre, Freeman Hospital, Newcastle, UK.
The Cochrane Database of Systematic Reviews
|August 11, 2021
Summary
This review compares treatments for great saphenous vein (GSV) incompetence, finding technical success comparable across most methods. Endovenous laser ablation (EVLA) may offer better success than ultrasound-guided foam sclerotherapy (UGFS) or high ligation and stripping (HL/S).
Area of Science:
- Vascular Surgery
- Minimally Invasive Procedures
- Evidence-Based Medicine
Background:
- Great saphenous vein (GSV) incompetence is a common cause of lower-limb venous diseases like varicose veins.
- Treatment options range from traditional surgery (high ligation and stripping) to newer endovenous techniques.
- Emerging treatments offer potential advantages such as avoiding general anesthesia and improving quality of life.
Purpose of the Study:
- To compare the effectiveness of various endovenous treatments for GSV varicosities.
- To assess outcomes including technical success, recurrence, complications, and quality of life.
- To update previous Cochrane reviews on GSV treatment efficacy.
Main Methods:
- Systematic review and meta-analysis of randomized controlled trials (RCTs).
- Searched multiple databases for studies comparing EVLA, RFA, EVSA, UGFS, cyanoacrylate glue, MOCA, and HL/S.
- Extracted data on key outcomes and assessed the certainty of evidence using GRADE.
Main Results:
- Technical success was comparable across most treatments, with EVLA potentially superior to UGFS and HL/S.
- High ligation and stripping (HL/S) may show better technical success than UGFS.
- Recurrence rates were similar, though radiofrequency ablation (RFA) showed a possible long-term benefit over EVLA and HL/S. Complications and quality of life were generally comparable.
Conclusions:
- Limited by study numbers and outcome heterogeneity, but EVLA may offer improved technical success over UGFS and HL/S.
- HL/S may be more effective than UGFS for technical success.
- Further research with standardized outcome measures is needed to clarify long-term benefits and comparisons between all modalities.
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