A comparison of the safety and efficacy of the VenaBlock cyanoacrylate-based endovenous system versus 1470 nm endovascular biradial laser in the treatment of truncal insufficiency of superficial veins: six-month outcomes of the ESVETIS observational study

Introduction
Current treatment of superficial vein insufficiency is based on minimally invasive methods, among them the VenaBlock system, a next-generation cyanoacrylate glue. The modified glue formula results in low viscosity and fast polymerisation, which may affect the accuracy and effectiveness of the treatment. The aim of our observational study was to assess the safety and efficacy of the VenaBlock system and compare it to near-infrared (1470 nm) laser thermoablation.

Material and methods
The study involved 87 patients allocated to either VenaBlock (n = 41) or laser (n = 46) groups. The assessment comprised selected morphometric parameters, duration of procedure, pain during and after procedure, occurrence of adverse events, changes in patients’ quality of life score, and effectiveness of vein closure during six-month follow-up.

Results
The VenaBlock procedure was shorter in comparison with laser treatment (7.1 ±4.6 vs. 17.0 ±4.2 minutes, respectively); pain during the procedure was more severe in the VenaBlock than in the laser group (3.5 ±2.3 vs. 2.7 ±2.0, respectively), but this difference was not statistically significant. However, one week after the treatment, pain was significantly more severe in the VenaBlock group (4.3 ±2.4 vs. 2.9 ±2.4, respectively). Neither serious adverse events nor other significant adverse reactions were observed. The six-month follow-up revealed a 90.3% occlusion rate in the VenaBlock group vs. 97.8% in the laser group; this difference was not statistically significant. However, the use of VenaBlock in larger veins was associated with higher risk of recanalisation.

Conclusions
The VenaBlock system is a safe and fast procedure, but its efficacy is limited in veins of large diameter.