Medical Adhesive (Glue) Method for Varicose Veins

The medical adhesive method is one of the most advanced methods among non-surgical varicose vein treatments. This treatment method is also called the "biological adhesive method" or "varicose veins treatment with gum."

In the leg vein ultrasonography examination, it is applied in case of the blood leaking backward from the deep vein on the groin to the superficial vein, namely, "venous reflux" or in case of a substantial enlargement of the superficial vein. The biologic adhesive method is applied to permanently close the big superficial vein in the inner part of the leg or the small superficial vein behind the calf. The biological adhesive agent N-butyl cyanoacrylate is in liquid form before application. It hardens and turns into a solid-state within seconds after inserted into a vein and contacted with blood. Thus, the vein is permanently closed. This new method is used all over the world and since 2014 in Turkey.

The procedure can be applied under operating room conditions or even in a patient’s bed. For the procedure, "local anesthesia" is sufficient to numb the region where the needle will be inserted. With the help of ultrasonography, a needle is inserted into the superficial vein. A plastic thin tube (catheter) is inserted into the vein through which the adhesive will be introduced. It is controlled with ultrasonography that the catheter tip is pushed into the appropriate point. Then, the required measures are taken to prevent the glue from leaking into the deep vein, and the biological adhesive is injected thoroughly into the vein, and its closure is provided.

In the biological adhesive method, the vein is not burned with heat energy as in the laser or radiofrequency method. Therefore, the biologic adhesive method provides some advantages over the laser or radiofrequency method.

• This procedure could be applied only by numbing the region where the needle is to be inserted (local anesthesia).
• During the procedure, injecting cold serum around the vein, namely, 'tumescent anesthesia,' is not required.
• Operation time is shorter than the intravenous laser or radiofrequency method.
• Since the heat energy is not applied, side effects such as burning, bruising, pain or numbness are absent on the skin after the procedure.
• Shortly after the procedure, the patient can go home on foot.
• The time to return to daily activities and work is even shorter.

During the first two weeks after the application of the biological adhesive method, the superficial veins are likely to be palpable, especially in patients with weaker subcutaneous fat tissue. However, this complaint disappears within a few months.

Some criteria are used in scientific studies to evaluate the success of varicose treatments. One of the most important of these is the rate of permanently closed veins treated in the leg vein ultrasonography examinations one year later. The vein closure rate after methods such as intravenous laser and radiofrequency applied with heat energy is similar to the vein closure rate after the medical adhesive method without heat energy. This finding indicates that the medical adhesive method is at least as effective as the methods that apply heat energy.