Abstract

OBJECTIVE: Cyanoacrylate Glue Closure (CAC) was first used in humans ten years ago to treat venous reflux of the axial veins. Studies have since shown its clinical efficacy in vein closure. However, there is much need to elucidate further, the types of specific adverse reactions that cyanoacrylate glue can cause, and to perform patient selection better and minimize these events. In this study, we systematically reviewed the literature to identify the types of reported reactions. In addition, we explored the pathophysiology contributing to these and proposed the mechanistic pathway with a showcase of actual cases.METHODS: We searched the literature for reports of reactions following cyanoacrylate glue use in patients with venous diseases between 2012 and 2022. The search was performed using Medical Subject Headings (MeSH) terms. The terms included cyanoacrylate, venous insufficiency, chronic venous disorder, varicose veins, vein varicosities, venous ulcer, venous wound, CEAP, vein, adverse events, phlebitis, hypersensitivity, foreign body granuloma, giant cell, endovenous glue induced thrombosis (EGIT), and allergy. The search was limited to the literature published in English. These studies were evaluated for the type of product used, and the reactions noted. A systematic review, according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) methodology, was performed. The COVIDENCE software was used for full-text screening and data extraction. Two reviewers reviewed the data, and the content expert served as the tiebreaker.RESULTS: One hundred and two records were identified, of which, thirty-seven records reported on cyanoacrylate use other than in the context of chronic venous diseases and were excluded. Fifty-five reports were determined appropriate for data extraction. The adverse reactions to cyanoacrylate glue were phlebitis, hypersensitivity, foreign body granuloma, and endovenous glue induced thrombosis (EGIT).CONCLUSIONS: Although cyanoacrylate glue closure for venous reflux is generally a safe and clinically effective treatment choice for symptomatic chronic venous disease patients with axial reflux, some adverse events may be specific to the properties of the cyanoacrylate product. We proposed mechanisms for how such reactions can occur based on histological changes, published reports, and case examples; however, further exploration is necessary to confirm these theories.

View details for DOI 10.1016/j.jvsv.2023.03.018

View details for PubMedID 37054883