Severe phlebitis-like abnormal reaction following great saphenous vein cyanoacrylate closure

J Vasc Surg Venous Lymphat Disord. 2019 Jul;7(4):578-582. doi: 10.1016/j.jvsv.2019.03.010. Epub 2019 May 8.

Abstract

The VenaSeal closure system is a nonthermal, nontumescent technique that was approved by the U.S. Food and Drug Administration in 2015 for the treatment of superficial venous insufficiency. Studies have demonstrated a comparable efficacy and safety profile to thermal ablation procedures. We report a case of a middle-aged woman who developed a severe, prolonged phlebitis-like reaction requiring treatment with steroids and antihistamines after cyanoacrylate adhesive embolization. This adverse reaction is uncommon but usually self-limiting and is believed to be a type IV hypersensitivity reaction to the cyanoacrylate compound. Knowledge of this potential complication and its treatment are key, because the reaction may be severe with significant morbidity.

Keywords: Allergic reaction; Cyanoacrylate embolization; Phlebitis; Venous insufficiency.

Publication types

  • Case Reports

MeSH terms

  • Aged
  • Cyanoacrylates / adverse effects*
  • Drug Hypersensitivity / diagnosis
  • Drug Hypersensitivity / drug therapy
  • Drug Hypersensitivity / etiology*
  • Embolization, Therapeutic / adverse effects*
  • Female
  • Histamine Antagonists / therapeutic use
  • Humans
  • Phlebitis / chemically induced*
  • Phlebitis / diagnosis
  • Phlebitis / drug therapy
  • Saphenous Vein / diagnostic imaging
  • Saphenous Vein / drug effects*
  • Severity of Illness Index
  • Steroids / therapeutic use
  • Treatment Outcome
  • Varicose Veins / diagnostic imaging
  • Varicose Veins / therapy*
  • Venous Insufficiency / diagnostic imaging
  • Venous Insufficiency / therapy*

Substances

  • Cyanoacrylates
  • Histamine Antagonists
  • Steroids