Alt Ekstremite Varis Hastalığında Endovenöz Siyanoakrilat Embolizasyonunun Orta-Uzun Dönem Sonuçlarının Değerlendirilmesi
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Evaluation of Middle-Long Term Results of Endovenous Cyanoacrylate Embolization in Lower Extremity Varicose Disease, Hacettepe University Faculty of Medicine, Thesis of Radiology, Ankara, 2017. The aim of this study was to evaluate the middle-long term results of endovenous cyanoacrylate embolisation in lower extremity varicose disease and compare its efficacy with other percutaneous procedures used in varicose disease. Patients who underwent endovenous cyanoacrylate embolisation between 1 April 2015 and 31 August December 2016 in Vascular Interventional Radiology Department were scanned retrospectively from the hospital electronic information system. 14 of 67 patients who underwent lower extremity endovenous cyanoacrylate embolisation between these dates, were excluded from the study due to lack of follow-up doppler ultrasound examination. In our study, cyanoacrylate embolisation was performed in 53 patients, total 69 vessels. Twenty (29.0%) of the treated patients were male and 49 (71.0%) were female. The mean age of the participants was 49.14 ± 14.37 (median age: 49, range 24-77). There were DVT stories in 2 cases (2.9%) of treated patients and no DVT stories in 67 cases (97.1%). Previously 2 (2.9%) patients underwent surgery, 3 (4.3%) patients had endovenous laser therapy and 1 (1.4%) patients had cyanoacrylate treatment. All patients underwent doppler ultrasound examination before the procedure. All of the procedures were performed under standard sterile conditions, without the patient receiving tumescent anesthesia. Major complications (such as DVT and pulmonary embolism) were not seen in any patient. 41 (59.4%) of the treated vessels were vena saphena magna (8 of them were below the knee segment), 21 (30.4%) were vena saphena parva and 7 (10.2%) were collateral, perforator and giacomini. In follow-up imaging, in 4 veins complete recanalisation and in 9 veins partial recanalization was found. When the recanalization status of the cases according to the length of embolisation vessel segment was examined, it was found that 5 (14.7%) were partial and 2 (5.9%) were complete recanalized of the short segment treated vessels; In long-segment treated group 4 (11.4%) were partial and 2 (5.7%) were complete recanalized. There was no statistically significant difference in recanalization status according to vessel segments. There was no statistically significant difference when vessel diameter value was compared with recanalization status. In conclusion, cyanoacrylate embolisation in lower extremity varicose disease is a safe technique that does not require tumescent anesthesia and can be used as an alternative to other conventional percutaneous methods.