Novel combination for complete ablation of incompetent great saphenous vein: Glue plus foam mid-term results

Background It is mostly challenging to ablate great saphenous vein (GSV) completely including the below-knee level. Objective The aim of this study was to evaluate the effectiveness of cyanoacrylate ablation (CAA) and catheter directed foam sclerotherapy (CDFS) combination in full length ablation of GSV with mid-term results. Materials and Methods Patients undergoing CAA and CDFS of the GSV between January 2015 and December 2021 were reviewed. Preoperative and postoperative CEAP class, symptoms, recurrence, and Doppler findings were compared. Results Postoperative overall closure rate at the first year was 99.5% ± 0.01 and at 5 years was found to be 93.8 ± 0.02%. Symptom free survival rate at the first year was 98.8% ± 0.01 and the cumulative 5-years symptom free survival rate was 73.0 ± 0.10%. Venous Clinical Severity Scores decreased from 5.9 ± 1.3 to 0.8 ± 0.4. Aberdeen Varicose Vein Questionnaire scores decreased from 19.7 ± 6.1 to 4.7 ± 1.8. Conclusion When techniques are evaluated, CAA and CDFS combination (Glue + Foam) may be preferable as a simple and shorter application with full-length complete occlusion of GSV and less early postoperative discomfort. Long-term outcomes and cost analyses of larger series still need to be documented.