Medical adhesive (cyanoacrylate)
VenaSeal for varicose veins
VenaSeal closes the diseased saphenous vein with a medical adhesive (cyanoacrylate) applied from the inside through a catheter. It is a non-thermal technique: it uses no heat and does not need the tumescent anaesthesia required for radiofrequency or laser.
Who is it for?
For saphenous vein reflux confirmed by duplex ultrasound. The 2022 European guideline considers it an alternative to thermal techniques. It can be particularly useful for patients who prefer to avoid multiple anaesthetic injections, or for veins close to nerves, where heat carries more risk.
How it is done
- With local anaesthesia only at the puncture site.
- Under ultrasound guidance, a catheter is inserted into the vein.
- Small amounts of adhesive are applied while the vein is compressed from the outside, segment by segment.
- The vein is sealed immediately.
Results
In the VeClose randomised trial, which compared VenaSeal with radiofrequency, the vein closure rate at 5 years was 91.4% with the adhesive and 85.2% with radiofrequency, showing it is non-inferior, with no serious adverse events at long-term follow-up.
Advantages
- No heat and no tumescent anaesthesia: fewer injections.
- Compression stockings are generally not needed afterwards.
- Immediate return to daily life.
- No hospital stay.
Possible side effects
Some people develop a local inflammatory reaction along the vein, similar to phlebitis, which usually settles within a few days with anti-inflammatories. Allergic reactions to the adhesive are uncommon, which is why I always ask about previous allergies.
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References
- Morrison N, Gibson K, Vasquez M, et al. Five-year extension study of patients from a randomized clinical trial (VeClose) comparing cyanoacrylate closure versus radiofrequency ablation for the treatment of incompetent great saphenous veins. J Vasc Surg Venous Lymphat Disord. 2020;8(6):978-989.
- De Maeseneer MG, Kakkos SK, Aherne T, et al. European Society for Vascular Surgery (ESVS) 2022 Clinical Practice Guidelines on the Management of Chronic Venous Disease of the Lower Limbs. Eur J Vasc Endovasc Surg. 2022;63(2):184-267.
Patient information reviewed by Dr Óscar Merino, vascular surgeon. It does not replace an individual medical assessment.
Would you like an assessment?
Consultation with duplex ultrasound at Clínica Rotger, in the centre of Palma.
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