Endovenous glue treatment is a new method for treating varicose veins. It involves injecting glue (n-butyl cyanoacrylate) into the main trunk of the great saphenous vein to seal the vein, replacing traditional laser or radiofrequency ablation techniques.

The endovenous glue treatment technique, initially introduced by Medtronic with VENASEAL in 2015, received approval from the U.S. Food and Drug Administration (FDA) and has gradually been promoted and used globally over the years. In early 2016, Dr. Smile Medical Group expert team observed this new technology in New Jersey.

Endovenous glue treatment is similar to sclerotherapy and is a non-surgical injection treatment method. Unlike sclerosants, it uses n-butyl cyanoacrylate as the injection material. The advantages include not requiring anesthesia, and the treatment process typically takes only a few minutes to half an hour. Patients can walk and resume normal activities immediately without the need for hospitalization.

However, it’s important to note that while endovenous glue treatment can show good short-term results, research is still ongoing to assess its long-term effectiveness and recurrence rate. Additionally, there may be complications associated with the introduction of closure glue into the bloodstream, which could pose challenges for retreatment in case of recurrence.

The main component of glue, n-butyl cyanoacrylate, is a medical adhesive that has been previously used for small skin wounds or incisions as an alternative to sutures.

While n-butyl cyanoacrylate is generally considered relatively safe for medical applications, injecting it into the blood vessels may cause some side effects:

Tissue irritation, including pain, inflammation, and scar formation, can occur when used for wound repair or vascular occlusion. Improper use can also result in adverse effects or complications, such as glue leakage or migration to undesired locations, causing discomfort, injury, or obstruction of other tissues or organs.

Some individuals may have allergic reactions to n-butyl cyanoacrylate, including itching, redness, pain, and rash. Allergic reactions can be acute or may occur months after treatment (delayed hypersensitivity reactions). Severe allergic reactions are rare but can cause greater harm to patients. Further discussion is needed to determine whether patch testing is necessary before treatment.

Compared to thermal ablation techniques like radiofrequency and laser, endovenous glue treatment still offers advantages such as no need for tumescent anesthesia and avoidance of heat-related damage. However, its application time is relatively short, and the number of cases is limited, requiring further observation and documentation of both short-term and long-term complications. The long-term safety of Endovenous glue treatment is not yet fully established. Therefore, when using this substance, the benefits and risks need to be carefully weighed, and the patient’s specific condition should be evaluated by a professional physician.

The occurrence of deep vein thrombosis due to adhesive agents is not common and often relates to the technique used. The incidence of deep vein thrombosis significantly decreases when the catheter is positioned 5 cm distal to the SFJ.

Overall, Endovenous glue treatment is still considered a method of obliterating the great saphenous vein, similar to the destructive principle of thermal ablation techniques.

With increasing attention and application of hemodynamic assessment and the CHIVA technique, the application of Endovenous glue treatment may require further changes and improvements to align with the hemodynamic treatment concept of varicose veins treastment.