Year 2020 Vol. 28 No 3

SCIENTIFIC PUBLICATIONS
GENERAL & SPECIAL SURGE

A.B. SANNIKOV 1, 2, E.V. SHAJDAKOV 3, V.M. EMELYNENKO 2, I.V. DROZDOVA 1, Y.A. DEMIDENKO 1

ON THE POSSIBILITY OF USING THE ADHESIVE COMPOSITION «SULFACRYLATE» FOR OBLITERATION OF VARICOSE VEINS OF THE LOWER EXTREMITIES

Medical Center «Palitra» 1, Vladimir,
N.I.Pirogov Russian National Research Medical University of the Ministry of Health 2, Moscow,
N.P. Bekhterev Institute of the Human Brain, RAS 3, St. Petersburg,
The Russian Federation

Objective. To conduct clinical experimental studies on the use of cyancrylate glue «Sulfacrylate» (produced in Russia) for obliteration the lower extremities varicose veins in humans.
Methods. Endovascular catheter obliteration of the tributaries and main trunks of the great saphenous vein on the tibia was performed in 15 patients with varicose disease (C2 to CEAR) in order to substantiate the possibility of using the adhesive compound «Sulfacrylate». Pain severity was clinically evaluated as well as presence or absence of phlebitis and thrombophlebitis, hyper pigmentation, neurological disorders, allergic reaction. Ultrasound control was carried out at various terms, starting from the 3rd day up to 6 months. Histological study of morphological changes was carried out selectively.
Results. All patients after the introduction of the glue «Sulfacrylate» had a clinic of moderate phlebitis, without the formation of blood clots in the lumen of the vein. No local or general allergic reaction was observed. Starting from the 7th day occluded venous segments were palpated in the form of moderate density bands without any infiltration of the surrounding tissues. In the absence of blood flow ultrasound examination showed gradual biodegradation of the adhesive strip inside the vein with the development of complete obliteration of the lumen starting from the 4th month. Starting from the 7th day aseptic inflammation in the wall of the vein was observed on histological examination which gradually stopped. Monocytic infiltration of the venous wall with the formation of multinucleated cells of foreign bodies was present until the complete biodegradation of the glue. The process of diffuse growth of connective tissue with the presence of fibroblasts from the subendothelium and in the middle shell was most actively observed in histological material from 90 to 120 days after occlusion. Within 180 days, the lumen of the veins occluded by "Sulfacrylate" was completely obliterated by mature connective tissue, in the absence of glue particles, which indicated its complete biodegradation.
Conclusions. The experimental studies conducted with the assessment of clinical symptoms, ultrasound examination and histological study of morphogenesis in the lumen of blood vessels in different periods up to 6 months allow us to conclude the potential use of the adhesive compound «Sulfacrylate» for endovasal obliteration of varicose veins in humans.

Keywords: cyanoacrylate embolization, non-thermal obliteration, non-tumescent obliteration, endovenous cyanoacrylate obliteration, varicose veins, cyanoacrylate medical glue "Sulfacrylate"
p. 258-267 of the original issue
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Address for correspondence:
600031, Russian Federation.,
Vladimir, Dobroselskaya str., 36b,
Medical Center «Palitra»,
tel.: 8(999) 776-47-73,
е-mail: aliplast@mail.ru,
Sannikov Alexander B.
Information about the authors:
Sannikov Alexander B., PhD, Head of the Surgical Department of the Medical Center «Palitra», Vladimir, Associate Professor of the Department of Continuing Education of Health Professionals, N.I.Pirogov Russian National Research Medical University of the Ministry of Health, Moscow, Russian Federation.
https://orcid.org/0000-0003-1792-2434
Drozdova Irina V., Functional Diagnostics Physician of the Medical Center «Palitra», Vladimir, Russian Federation.
https://orcid.org/0000-0002-2430-053X
Demidenko Yaroslav A., PhD, Head Physician of the Medical Center «Palitra», Vladimir, Russian Federation.
https://orcid.оrg/0000-0002-7944-1516
Shajdakov Evgeny V., MD, Professor, N.P. Bekhterev Institute of the Human Brain, RAS, St. Petersburg, Russian Federation
https://orcid.org/0000-0002-7260-4968
Emelynenko Vladimir M., MD, Professor, Head of the Professor of the Department of Continuing Education of health Professionals, N.I. Pirogov Russian National Research Medical University of the Ministry of Health, Moscow, Russian Federation.
https://orcid.org/0000-0003-0909-1693
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