Dr. John Happel | Sep 22, 2018 | 0
Varicose Vein Glue: A Sticky Subject – Happel Laser & Vein Centre
Varicose Vein Glue is the New Kid on the Block
In the world of varicose vein treatments, there’s a new kid on the block. It’s varicose vein glue or a form of Krazy glue or some call it Super glue.
Question: How do you fix a broken tuba?
Answer: A tuba glue
Question: How do you fix Superman’s costume?
Answer: Super Glue
Question: How do you fix varicose veins?
Answer: A tuba Superglue
How Does the Doctor Use Glue for Varicose Veins?
The latest method of treating varicose veins is the use of medical glue known as cyanoacrylate.
This glue will seal and close off the defective targeted vein. That vein and the glue will eventually be absorbed.
There are no harmful long-term effects from the glue.
Through early trials like the VeClose study, we have learned that the varicose vein glue procedure is safe and effective. A study called the eScope demonstrated a closure rate of 94.3% after 6 months and 92.9% after 12 months.
The procedure used to glue varicose veins in the leg involves the placement of a very small amount of special medical glue into the targeted vein through a tiny catheter.
The veins that are treated are called the saphenous veins. The saphenous veins are the ones that are presently closed using laser or radiofrequency.
Varicose veins are usually branches from the saphenous veins. The confusing part is that the varicose veins themselves are not treated first.
In fact, the varicose veins themselves cannot ususally be treated with glue.
For most patients, the saphenous vein is closed with glue, laser or radiotherapy. Later the varicose vein branches that you see on the skin’s surface can be addressed.
Usually the varicose veins themselves are treated with either sclerotherapy or removed with a technique called phlebectomy. With phlebectomy, the varicose veins are removed through tiny mini incisions or needle holes under local anesthesia.
After the saphenous and varicose vein branches are closed, blood is re-routed through the remaining healthy veins in the leg. There are many nearby superficial veins and deep veins that are all interconnected.
These connections already exist. You don’t have to grow new veins to replace the ones that are closed or removed.
An advantage to the glue procedure for closing the saphenous veins is that it can be performed through insertion of a catheter using local anesthesia. Only one small spot needs to be numbed.
With laser and radiofrequency closure, a tube of anesthetic fluid needs to be injected all around this long vein. It is called tumescent anesthesia.
Tumescent anesthesia requires multiple pinches of anesthetic. Inserting this anesthetic around the saphenous vein takes most of the time during the twenty to thirty minute procedure.
Advantages of Varicose Vein Glue
- With the glue procedure, tumescent anesthesia is not required.
- Therefore, it is faster and less pinching or local anesthesia is required.
- There is less bruising and discomfort.
- Since there is no heat involved so there is less inflammation after the procedure.
- There is no risk of burns or nerve damage.
- Anti-inflammatory and pain medication may be required after the glue procedure but often for a shorter time.
- A huge advantage is that support stockings are not required.
However, remember the glue procedure alone will not rid you of the varicose vein branches on the skin’s surface that you see.
Sclerotherapy or phlebectomy is still required in many cases just like after the laser or radiofrequency closure procedure of the saphenous vein.
Vigorous exercise is discouraged after the procedure. However, normal activity is recommended right away.
Not everyone with varicose veins is a candidate for the varicose vein glue procedure.
Before you can have it done, you still need a Doppler ultrasound test and a clinical examination by a qualified vein specialist to determine if it can even be performed on your varicose veins.
History of the Use of Glue to Treat Vessels
One of the first uses of medical glue was to treat arterio-venous malformations in the brain described by Luessenhop in 1960.
Arteriovenous malformations are abnormal connections between an artery and a nearby vein.
Arteriovenous malformations can occur anywhere within the brain or its surface.
They can cause bleeding, seizures, and pain. The risk of bleeding is 10-15% with each bleeding episode.
This idea of blocking off abnormal blood vessels with glue was extrapolated to varicose veins.
Dr Jose Almeida in the Journal of Vascular Surgery published the first use of glue in humans for varicose veins. This trial was presented at the Twenty-fourth Annual Meeting of the American Venous Forum, Orlando, on February 8-11, 2012.
Subsequently, a twelve-month follow up on a European trial of glue used to treat varicose veins was published in January 2014 in the Journal of Vascular Surgery. 8.7% of these patients developed a clot in the remaining varicose veins called thrombophlebitis.
Thirty-eight veins in 38 symptomatic patients were treated. Clinical follow up and ultrasound imaging were performed.
More studies are being done with close follow up to make sure it is safe and durable for varicose vein treatment.
Why Aren’t We Using Glue Now for Varicose Veins?
At the present time, glue treatment for varicose veins does not currently have an insurance procedure code.
It is not covered by any medical insurance.
It is available only to patients who wish to pay for the procedure out-of-pocket.
Glue for varicose veins was recently FDA approved about one year ago.
The varicose vein glue system originated with a company called Sapheon. In 2014, Sapheon was bought by Covidien. Medtronic later bought Covidien. Medtronic is the present manufacturer of this product.
Medtronic is working hard to get the insurance code approved. It will take a couple of years.
The future for varicose vein glue does look promising.
The published short-term results show a 98.9% success rate after six months. At the present time, we don’t know the long-term results because it is so new.
What’s the difference between a tuna, a piano and a tube of Super glue?
You can tuna piano but you can’t piano a tuna.
What about the Super glue?
I knew you’d get stuck there.
At the present time, health insurance companies consider glue for varicose veins to be investigational.
Therefore, no insurance company is covering its cost. The cost is around $3500 out-of-pocket. It will probably take two to three years for an insurance code to be approved for this procedure.
Some discomfort is involved which usually goes away in days to weeks. Anti-inflammatory medicine is recommended. Complications can occur but are rare.
Not everyone is a candidate for the varicose vein glue procedure.
A big advantage is that you do not have to wear support stockings after its use.
The long-term results are not known but it looks promising.
However, traditional methods of varicose vein treatment including laser therapy, sclerotherapy, and phlebectomy show almost perfect results. Compared to the old stripping operation for varicose veins, these methods are very effective.
Call us at 724-969-0600 or click here to learn more.
Until glue for varicose vein treatment is approved for use and is no longer considered investigational, we’ll leave the laser on for you!