title: The European multicenter cohort study on cyanoacrylate embolization of refluxing great saphenous veins.
abstract: OBJECTIVE
  Cyanoacrylate (CA) embolization of refluxing great saphenous veins (GSVs) has been previously described. The outcomes from a multicenter study are still lacking.
  
  
  METHODS
  A prospective multicenter study was conducted in seven centers in four European countries to abolish GSV reflux by endovenous CA embolization. Neither tumescent anesthesia nor postinterventional compression stockings were used. Varicose tributaries remained untreated until at least 3 months after the index treatment. Clinical examination, quality of life assessment, and duplex ultrasound evaluation were performed at 2 days and after 1, 3, 6, and 12 months.
  
  
  RESULTS
  In 70 patients, of whom 68 (97.1%) were available for 12-month follow-up, 70 GSVs were treated. Two-day follow-up showed one proximal and one distal partial recanalization. Three additional proximal recanalizations were observed at 3-month (n = 2) and 6-month (n = 1) follow-up. Cumulative 12-month survival free from recanalization was 92.9% (95% confidence interval, 87.0%-99.1%). Mean (standard deviation) Venous Clinical Severity Score improved from 4.3 ± 2.3 at baseline to 1.1 ± 1.3 at 12 months. Aberdeen Varicose Vein Questionnaire score showed an improvement from 16.3 at baseline to 6.7 at 12 months (P < .0001). Side effects were generally mild; a phlebitic reaction occurred in eight cases (11.4%) with a median duration of 6.5 days (range, 2-12 days). Pain without a phlebitic reaction was observed in five patients (8.6%) for a median duration of 1 day (range, 0 -12 days). No serious adverse event occurred. Paresthesia was not observed.
  
  
  CONCLUSIONS
  Endovenous CA embolization of refluxing GSVs is safe and effective without the use of tumescent anesthesia or compression stockings.
authors.affiliation: Department of Dermatology, University Medical Center, Mainz, Germany. Electronic address: thomas.proebstle@web.de.
authors.forename: Thomas Michael
authors.initials: TM
authors.lastname: Proebstle
authors.affiliation: Dermatologikum Hamburg, Hamburg, Germany.
authors.forename: Jens
authors.initials: J
authors.lastname: Alm
authors.affiliation: Countess of Chester Hospital, Chester, United Kingdom.
authors.forename: Sameh
authors.initials: S
authors.lastname: Dimitri
authors.affiliation: The Danish Vein Centers, Naestved, Denmark.
authors.forename: Lars
authors.initials: L
authors.lastname: Rasmussen
authors.affiliation: The Whiteley Clinic, Guildford, United Kingdom.
authors.forename: Mark
authors.initials: M
authors.lastname: Whiteley
authors.affiliation: Centrum Oosterwal, Alkmaar, The Netherlands.
authors.forename: James
authors.initials: J
authors.lastname: Lawson
authors.affiliation: Wild Iris Consulting LLC, Palo Alto, Calif.
authors.forename: Daniel
authors.initials: D
authors.lastname: Cher
authors.affiliation: Imperial College London, London, United Kingdom.
authors.forename: Alun
authors.initials: A
authors.lastname: Davies
mesh_terms: D015331:Cohort Studies; D003487:Cyanoacrylates; D004621:Embolization, Therapeutic; D005060:Europe; D006801:Humans; D011446:Prospective Studies; D011788:Quality of Life; D012501:Saphenous Vein / Q000473:pathology / Q000503:physiopathology / Q000601:surgery; D016896:Treatment Outcome; D014689:Venous Insufficiency / Q000628:therapy*
chemical_list: D003487:Cyanoacrylates