Venous insufficiency, which commonly manifests as varicose veins, can be treated fast and painlessly Dr Chong Tze Tec, Senior Consultant and Head, Department of Vascular Surgery, Singapore General Hospital, explains.
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Inject, glue and seal.
This about sums up the latest treatment for venous insufficiency, a condition where blood flows back towards the feet instead of returning to the heart because of faulty vein valves, and which commonly manifests as varicose veins.
“Treatment is simple, painless and fast,” said
Dr Chong Tze Tec, Senior Consultant and Head,
Department of Vascular Surgery,
Singapore General Hospital (SGH), a member of the
“There is minimal or no bruising at all, and patients can resume their normal activities immediately without having to wear compression stockings afterwards.”
Venous insufficiency: Superglue treatment introduced
The procedure makes use of cyanoacrylate adhesive, a medicalgrade superglue which has been used in surgeries and other treatments since the 1950s. Its use in the treatment of venous insufficiency was approved by the US Food and Drug Administration in 2015, and by Singapore’s Health Sciences Authority in 2016.
SGH started offering the treatment in the first quarter of 2016, and since then, more than 100 patients have opted for it.
How is the procedure performed
In the procedure, done under local anaesthesia, a small tube or catheter is inserted into the diseased vein. Ultrasound is used to guide and position the catheter along segments of the vein, and then small amounts of the superglue is pumped through the catheter at 3cm intervals and pressed down – three minutes for the first seal and 30 seconds for the subsequent portions. No suturing or stitching is needed – just an adhesive plaster that is placed over the puncture wound.
While not everyone who suffers from venous insufficiency or reflux has varicose veins, those who do can have the large, twisted veins removed after the superglue procedure.
Surgeons make small incisions – 3mm into the skin – to “pull out the veins”, said Dr Chong.
Stab avulsion is usually done under local anaesthesia, but if many or large veins have to be taken out, it is done under general anaesthesia, he added.
As with other methods to close or take out diseased veins, blood is rerouted to other, healthy veins.
Comparing superglue treatment with conventional treatments
Conventional methods of treating the condition include stripping, an invasive and painful option that involves removing the diseased veins surgically, and requires a recovery period of weeks.
Radiofrequency and laser ablation are other methods, but the use of intense heat to seal diseased veins can injure or darken the skin, especially slim patients whose veins are close to the skin. Some treatments also require multiple injections.
Patients who undergo conventional treatments usually take a longer time to recover. They also have to wear compression stockings for one to three weeks after treatment, which can be uncomfortable in Singapore’s hot and humid weather. With the superglue treatment, patients are able to go home within an hour of the procedure.
According to some studies, the superglue method is as effective as conventional techniques. The condition did not recur for 99 per cent of patients three months after the procedure, and for 94 per cent after two years.
See previous page for the
symptoms of venous insufficiency, who are at risk and why the condition can easily go unnoticed until it becomes severe.