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Occlusion of the Great and Small Saphenous Vein Using Copolymeric Glue Based on N-Butyl Cyanoacrylate and Methacryloxy Sulfolane

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[LONG-TERM RESULTS OF TREATMENT OF PATIENTS WITH VARICOSE DISEASE AFTER USING ASVAL TECHNIQUE].

A Chernookov¹, V Ramishvili², S Kandyba³

¹1Moscow State University of Food Production, Department of Damage Surgery; 2Center of Phlebology, Moscow.

Georgian Medical News

|December 13, 2021

Summary

The ASVAL technique effectively treats lower limb varicose disease, improving quality of life for 62% of patients by reducing venous reflux. However, a high relapse rate necessitates caution in its widespread adoption.

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Area of Science:

Vascular Surgery
Phlebology

Background:

Varicose disease of the lower limbs affects a significant portion of the population.
Saphenofemoral junction failure and venous reflux are key indicators of disease severity.
Minimally invasive techniques are sought to improve treatment outcomes and patient quality of life.

Purpose of the Study:

To evaluate the effectiveness and safety of the ASVAL (Access, Secure, Validate, Ablate, Ligate) technique for treating lower limb varicose disease.
To assess the impact of ASVAL on patient-reported quality of life indicators.
To analyze short-term and long-term outcomes, including complication rates and disease recurrence.

Main Methods:

Prospective evaluation of 84 patients (18-57 years) with lower limb varicose disease undergoing the ASVAL technique.
ASVAL involved miniflebectomy of varicose tributaries with great saphenous vein preservation under local anesthesia.
Outcomes assessed included operative time, postoperative pain (Visual Analogue Scale), early complications, saphenofemoral junction diameter, reflux disappearance, disease relapse, and quality of life (CIVIQ 2 questionnaire) at 1-year follow-up.

Main Results:

The ASVAL procedure was performed in 22-45 minutes with low postoperative pain (average 2.6/10).
Early complications were infrequent (hematoma 1.2%, thrombosis 2.4%, neurological disorders 2.4%).
At 1 year, 62% of patients showed disappearance of reflux, and quality of life improved by 20.3-30.9%. However, a 11.9% relapse rate was observed.

Conclusions:

The ASVAL technique is a safe and low-traumatic method for managing lower limb varicose disease.
It effectively reduces venous reflux and significantly improves patients' quality of life.
Despite its benefits, the observed high rate of disease relapse warrants further investigation and may limit its widespread recommendation.