Cyanoacrylate adhesive perforator embolization (CAPE) of incompetent perforating veins of the leg, a feasibility study.
Consideration of treating incompetent perforating veins remains a conundrum based on scientific evidence available till date. While subfascial endoscopic perforator surgery (SEPS) proved to be a worthy alternative for open surgery, other even less invasive techniques were being introduced by the late nineties of the last century. Percutaneous thermo-ablation techniques are still being used today and seem more effective than non-thermal techniques. However, thermal techniques require anaesthesia and potentially may cause inadvertent damage to surrounding tissues such as nerves. Cyanoacrylate adhesive has a proven record, but not for the treatment of chronic venous disease of the leg. Innovation has led to the development of the VenaSeal® Sapheon Closure System which has been designed to use a modified cyanoacrylate glue as a new therapy for truncal vein incompetence. This paper explores the feasibility of ultrasound guided cyanoacrylate adhesive perforator embolization (CAPE). Results show a 76% occlusion rate of incompetent perforating veins without serious complications leading to the conclusion that further investigation with a dedicated delivery device in a larger patient population is warranted.
Maastricht University Medical Centre, Department of Vascular Surgery, the Netherlands toonder@gmail.com.
Irwin M
IM
Toonder
Maastricht University Medical Centre, Department of Vascular Surgery, the Netherlands.
Yee Lai
YL
Lam
Maastricht University Medical Centre, Department of Dermatology, the Netherlands.
James
J
Lawson
Maastricht University Medical Centre, Department of Vascular Surgery, the Netherlands Universitätsklinikum Aachen, Dept of Vascular Surgery, Germany.
Cees Ha
CH
Wittens
Cyanoacrylate; Sapheon; VenaSeal®; embolization; perforating vein; ultrasound