Abstract

Aim: Primary varicose vein is still one of the most prevalent venous disorders, faced daily in the surgical practice. Shifting from surgical intervention to endovenous interventions (thermal or non-thermal) is currently the standard practice because of their better results and patients’ satisfaction. The aim of our study is to compare vein closure rate and overall venous thrombosis, 12 months after either Cyanoacrylate or endovenous laser treatment for Great Saphenous vein incompetence.
Material and Methods: The study was a retrospective study analyzing the data of 126 lower limbs in 120 patients with Great Saphenous vein (GSV) incompetence who underwent either Cyanoacrylate closure (CAC) or Endovenous Laser Ablation (EVLA) and were followed for 12 months between Jan. 2022 and March 2025. Vein closure and thrombosis rates were our primary endpoints. Sixty patients with 66 limbs had EVLA. We used (VenaSeal, Medtronic) for CAC and (Ceralas E Biolitec 1470nm WL, ELVeS, Radial fiber Diode) for EVLA.
Results: A total of 126 lower limbs in 120 patients were treated, the atients were between 18 and 65 years old (mean age was 38 +/- 12 years) and 65% of them were females. They were followed for 12 months (48% had complete 12-month follow up). Vein closure rates were 100% in both modalities (1-month period), 97% in EVLA and 100% in CAC-patients (6-month period) and 94% in EVLA-patients and 96% in CAC-patients (12-month period). It was found that 3% of EVLA-patients had Endovenous Heat Induced thrombosis (EHIT) and 2% of CAC-patients had Endovenous Glue Induced Thrombosis (EGIT) with no incidence of Deep Vein Thrombosis (DVT) during the follow up period.
Conclusion: Cyanoacrylate vein closure results were not inferior to laser vein treatment in great saphenous varicose veins, nevertheless Cyanoacrylate surpassed Laser treatment in six and twelve-month vein closure rate. Both modalities were safe and free of major venous thrombosis.

Key words: Varicose veins, Endovenous therapy, Laser thermocoagulation, Cyanoacrylate