Three-year outcomes after cyanoacrylate closure of superficial truncal veins: A single-center practice cohort study.

objectiveThe aim of this study was to evaluate mid-term durability, clinical outcomes, and patient-reported outcomes after cyanoacrylate closure (CAC) of superficial truncal veins in routine practice, with limb- and vein-level analyses.

methodsThis was a single-center, retrospective cohort study of adults previously treated with CAC of the great saphenous vein, small saphenous vein, anterior saphenous vein, or posterior accessory saphenous vein, with standardized follow-up assessments. Eligible patients were invited for standardized follow-up including duplex ultrasound, CEAP class, revised Venous Clinical Severity Score, EuroQol 5-dimension survey, and Aberdeen Varicose Vein Questionnaire. The primary endpoint was complete closure of the primary target vein on duplex ultrasound, defined as no ≥5-cm contiguous patency within the treated segment. Secondary endpoints included vein-level patency, new clinically significant varicose veins, adverse events, and satisfaction with symptoms and cosmetic appearance. Analyses accounted for clustering of veins/limbs within patients using generalized estimating equations.

resultsThe study enrolled 89 patients (76.4% female; median age, 53 years) representing 110 limbs and 156 treated veins. The median time from treatment to follow-up was 3.7 years. Primary target vein complete closure at the limb level was 97.3% (107/110; 95% confidence interval [CI], 91.9%-99.1%). At follow-up, patency in any treated vein was present in 10.9% of limbs and 7.7% of veins. At follow-up, revised Venous Clinical Severity Score decreased from 6 (interquartile range, 4-8) to 1 (interquartile range, 0-2) (mean change, -4.5 ± 2.5; P < .001) and Aberdeen Varicose Vein Questionnaire scores improved among the subset with paired data (mean change, -7.7 ± 8.9; P < .001). New clinically significant varicose veins were present in 19.1% of limbs (95% CI, 12.7%-27.8%), often involving the anterior saphenous vein. Higher baseline body mass index was associated with vein-level patency on univariable analysis (median 33 vs 24 kg/m

conclusionsComplete closure rates of all treated veins with CAC remain high at a median of 3.7 years post treatment with sustained clinical and patient-reported outcome improvements. Incomplete closure and recurrent varicose veins correlate with worse symptoms, visual appearance and patient satisfaction.