Jiwoo Lee, Chien Yi Maximilian Png, Bianca Mulaney-Topkar, Davis Waller, Vishu Chandrasekhar, Julianne Stoughton
{"title":"氰基丙烯酸酯关闭下肢浅静脉患者超敏反应的回顾性研究。","authors":"Jiwoo Lee, Chien Yi Maximilian Png, Bianca Mulaney-Topkar, Davis Waller, Vishu Chandrasekhar, Julianne Stoughton","doi":"10.1016/j.jvsv.2025.102246","DOIUrl":null,"url":null,"abstract":"<p><strong>Objective: </strong>Chronic venous insufficiency affects more than 25 million adults in the United States, who initially presents with varicose veins. Although thermal-based, minimally invasive endovenous procedures exist, there has been a recent advent of non-thermal endovenous methods for vein ablation such as cyanoacrylate closure (CAC) with the VenaSeal Closure System, which decreases the risk of thermal injury. This study aimed to determine the incidence, onset, duration, and severity of hypersensitivity reactions (HSRs) following CAC, as well as identify risk factors for the development of HSRs.</p><p><strong>Methods: </strong>This study was conducted at the Massachusetts General Brigham health care system and included 122 patients with 193 veins treated between 2018 and 2022. Patients aged 18 years and older with symptomatic, incompetent superficial lower extremity veins, including the great saphenous vein, small saphenous vein, and anterior accessory saphenous vein, were included. Data on patient demographics, clinical history, procedure details, and post-procedural duplex ultrasound results were collected.</p><p><strong>Results: </strong>In this cohort, the incidence of HSRs was 21.2%. Symptom onset occurred on average 7.6 days post-procedure (standard deviation, 7.4 days) with most patients experiencing mild (76%) or moderate (24%) symptoms that resolved without intervention, with non-steroidal anti-inflammatory drugs, or with steroid treatment. There was a significantly higher risk of HSRs with younger age (P = .0372), female sex (P = .0025), and history of allergies (P = .0049). Longer veins (P = .0205) and greater saphenous veins (P = .0388) had stronger associations with HSRs. The overall postoperative closure rate after CAC procedure was 99.5%, without a significant difference between patients with and without HSRs.</p><p><strong>Conclusions: </strong>HSRs are a potential adverse complication of the CAC procedure, with most cases being self-limited and affecting individuals who are younger, are female, and have a history of allergies. These findings suggest the need for careful patient selection and counseling during consideration of the CAC procedure for the treatment of chronic venous insufficiency.</p>","PeriodicalId":17537,"journal":{"name":"Journal of vascular surgery. Venous and lymphatic disorders","volume":" ","pages":"102246"},"PeriodicalIF":2.8000,"publicationDate":"2025-04-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12099872/pdf/","citationCount":"0","resultStr":"{\"title\":\"Retrospective study of hypersensitivity reactions in patients undergoing cyanoacrylate closure of lower extremity superficial veins.\",\"authors\":\"Jiwoo Lee, Chien Yi Maximilian Png, Bianca Mulaney-Topkar, Davis Waller, Vishu Chandrasekhar, Julianne Stoughton\",\"doi\":\"10.1016/j.jvsv.2025.102246\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<p><strong>Objective: </strong>Chronic venous insufficiency affects more than 25 million adults in the United States, who initially presents with varicose veins. Although thermal-based, minimally invasive endovenous procedures exist, there has been a recent advent of non-thermal endovenous methods for vein ablation such as cyanoacrylate closure (CAC) with the VenaSeal Closure System, which decreases the risk of thermal injury. This study aimed to determine the incidence, onset, duration, and severity of hypersensitivity reactions (HSRs) following CAC, as well as identify risk factors for the development of HSRs.</p><p><strong>Methods: </strong>This study was conducted at the Massachusetts General Brigham health care system and included 122 patients with 193 veins treated between 2018 and 2022. Patients aged 18 years and older with symptomatic, incompetent superficial lower extremity veins, including the great saphenous vein, small saphenous vein, and anterior accessory saphenous vein, were included. Data on patient demographics, clinical history, procedure details, and post-procedural duplex ultrasound results were collected.</p><p><strong>Results: </strong>In this cohort, the incidence of HSRs was 21.2%. Symptom onset occurred on average 7.6 days post-procedure (standard deviation, 7.4 days) with most patients experiencing mild (76%) or moderate (24%) symptoms that resolved without intervention, with non-steroidal anti-inflammatory drugs, or with steroid treatment. There was a significantly higher risk of HSRs with younger age (P = .0372), female sex (P = .0025), and history of allergies (P = .0049). Longer veins (P = .0205) and greater saphenous veins (P = .0388) had stronger associations with HSRs. The overall postoperative closure rate after CAC procedure was 99.5%, without a significant difference between patients with and without HSRs.</p><p><strong>Conclusions: </strong>HSRs are a potential adverse complication of the CAC procedure, with most cases being self-limited and affecting individuals who are younger, are female, and have a history of allergies. These findings suggest the need for careful patient selection and counseling during consideration of the CAC procedure for the treatment of chronic venous insufficiency.</p>\",\"PeriodicalId\":17537,\"journal\":{\"name\":\"Journal of vascular surgery. 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Venous and lymphatic disorders","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.1016/j.jvsv.2025.102246","RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q2","JCRName":"PERIPHERAL VASCULAR DISEASE","Score":null,"Total":0}
Retrospective study of hypersensitivity reactions in patients undergoing cyanoacrylate closure of lower extremity superficial veins.
Objective: Chronic venous insufficiency affects more than 25 million adults in the United States, who initially presents with varicose veins. Although thermal-based, minimally invasive endovenous procedures exist, there has been a recent advent of non-thermal endovenous methods for vein ablation such as cyanoacrylate closure (CAC) with the VenaSeal Closure System, which decreases the risk of thermal injury. This study aimed to determine the incidence, onset, duration, and severity of hypersensitivity reactions (HSRs) following CAC, as well as identify risk factors for the development of HSRs.
Methods: This study was conducted at the Massachusetts General Brigham health care system and included 122 patients with 193 veins treated between 2018 and 2022. Patients aged 18 years and older with symptomatic, incompetent superficial lower extremity veins, including the great saphenous vein, small saphenous vein, and anterior accessory saphenous vein, were included. Data on patient demographics, clinical history, procedure details, and post-procedural duplex ultrasound results were collected.
Results: In this cohort, the incidence of HSRs was 21.2%. Symptom onset occurred on average 7.6 days post-procedure (standard deviation, 7.4 days) with most patients experiencing mild (76%) or moderate (24%) symptoms that resolved without intervention, with non-steroidal anti-inflammatory drugs, or with steroid treatment. There was a significantly higher risk of HSRs with younger age (P = .0372), female sex (P = .0025), and history of allergies (P = .0049). Longer veins (P = .0205) and greater saphenous veins (P = .0388) had stronger associations with HSRs. The overall postoperative closure rate after CAC procedure was 99.5%, without a significant difference between patients with and without HSRs.
Conclusions: HSRs are a potential adverse complication of the CAC procedure, with most cases being self-limited and affecting individuals who are younger, are female, and have a history of allergies. These findings suggest the need for careful patient selection and counseling during consideration of the CAC procedure for the treatment of chronic venous insufficiency.
期刊介绍：
Journal of Vascular Surgery: Venous and Lymphatic Disorders is one of a series of specialist journals launched by the Journal of Vascular Surgery. It aims to be the premier international Journal of medical, endovascular and surgical management of venous and lymphatic disorders. It publishes high quality clinical, research, case reports, techniques, and practice manuscripts related to all aspects of venous and lymphatic disorders, including malformations and wound care, with an emphasis on the practicing clinician. The journal seeks to provide novel and timely information to vascular surgeons, interventionalists, phlebologists, wound care specialists, and allied health professionals who treat patients presenting with vascular and lymphatic disorders. As the official publication of The Society for Vascular Surgery and the American Venous Forum, the Journal will publish, after peer review, selected papers presented at the annual meeting of these organizations and affiliated vascular societies, as well as original articles from members and non-members.
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