Journal of vascular surgery. Venous and lymphatic disorders · 2026
Management of recanalization after cyanoacrylate closure: A single-center experience.
СтатьяНазвание и аннотация: Перевод в очереди
Обработка статьи · этапы, ошибки и управление
Загрузка состояния…
Ошибки и ограничения
История · было → стало
Состояние обновляется каждые 5 секунд, пока блок открыт. Процент показывается только там, где известен объём работы. Пауза останавливает продолжение этапа; текущий запрос к источнику может завершиться.
Murayama Takaya, Sujino Kazuyo, Yamashita Mitsumi
Аннотация
OBJECTIVE: Cyanoacrylate closure (CAC) is an established treatment for lower-extremity varicose veins. Recanalization after CAC is an uncommon but clinically relevant event for which optimal management strategies have not been well described. The objective of this study was to retrospectively review cases of CAC recanalization at a single center and to descriptively evaluate the secondary treatment approaches, including ultrasound-guided foam sclerotherapy (UGFS), endovenous laser ablation (EVLA), and radiofrequency ablation (RFA).
METHODS: We retrospectively reviewed 335 patients who underwent CAC procedures at Kannai Medical Clinic between August 2020 and November 2025. Recanalization was defined as partial or complete restoration of luminal flow within the treated vein segment on duplex ultrasound during follow-up. The detailed definition of recanalization is as follows: reflux flow of 0.5 seconds or more, being compressible, a segment length of 5 cm or more, and symptomatic cases. Twenty-three cases with recanalization were identified and analyzed. Treatment outcomes following UGFS, 1470 nm EVLA, or RFA were assessed. In addition, as a supplement, a preliminary ex vivo experiment was conducted to observe the effects of laser ablation, RFA, and polidocanol on cyanoacrylate (CA) polymerized with blood.
RESULTS: Among the 23 recanalization cases, recanalization patterns were frequently discontinuous and irregular. UGFS was performed in 15 cases, and recanalization was successfully occluded in 12 cases (80%). EVLA was performed in 2 cases; one required multiple direct punctures because of complex recanalization, and recanalization was successfully occluded in both cases. However, deformation of CA was observed by ultrasound during laser ablation. RFA was performed in 7 cases using multiple direct punctures with a 12G needle with a plastic cannula; all procedures were completed without CA deformation and with favorable occlusion. In the ex vivo experiment, laser ablation caused CA deformation and carbonization, and temperature measurement reached 193 to 200 °C during ablation in CA, whereas RFA produced no structural changes with 80 to 93 °C temperature. Polidocanol had no observable effect on CA.
CONCLUSIONS: Recanalization after CAC demonstrates heterogeneous and often discontinuous patterns. UGFS achieved successful occlusion at an 80% success rate. UGFS may be an effective first-line treatment in many cases. EVLA and RFA were technically feasible in selected cases, without observed complications. Laser ablation may have unique interactions with polymerized CA, as suggested by preliminary experimental observations. However, these observations are exploratory and require further clinical validation. Careful consideration is warranted when selecting secondary treatment modalities for CAC recanalization.
METHODS: We retrospectively reviewed 335 patients who underwent CAC procedures at Kannai Medical Clinic between August 2020 and November 2025. Recanalization was defined as partial or complete restoration of luminal flow within the treated vein segment on duplex ultrasound during follow-up. The detailed definition of recanalization is as follows: reflux flow of 0.5 seconds or more, being compressible, a segment length of 5 cm or more, and symptomatic cases. Twenty-three cases with recanalization were identified and analyzed. Treatment outcomes following UGFS, 1470 nm EVLA, or RFA were assessed. In addition, as a supplement, a preliminary ex vivo experiment was conducted to observe the effects of laser ablation, RFA, and polidocanol on cyanoacrylate (CA) polymerized with blood.
RESULTS: Among the 23 recanalization cases, recanalization patterns were frequently discontinuous and irregular. UGFS was performed in 15 cases, and recanalization was successfully occluded in 12 cases (80%). EVLA was performed in 2 cases; one required multiple direct punctures because of complex recanalization, and recanalization was successfully occluded in both cases. However, deformation of CA was observed by ultrasound during laser ablation. RFA was performed in 7 cases using multiple direct punctures with a 12G needle with a plastic cannula; all procedures were completed without CA deformation and with favorable occlusion. In the ex vivo experiment, laser ablation caused CA deformation and carbonization, and temperature measurement reached 193 to 200 °C during ablation in CA, whereas RFA produced no structural changes with 80 to 93 °C temperature. Polidocanol had no observable effect on CA.
CONCLUSIONS: Recanalization after CAC demonstrates heterogeneous and often discontinuous patterns. UGFS achieved successful occlusion at an 80% success rate. UGFS may be an effective first-line treatment in many cases. EVLA and RFA were technically feasible in selected cases, without observed complications. Laser ablation may have unique interactions with polymerized CA, as suggested by preliminary experimental observations. However, these observations are exploratory and require further clinical validation. Careful consideration is warranted when selecting secondary treatment modalities for CAC recanalization.