Original Article Mıd-term results ın the treatment of varı cose veıns wıth N-butyl cyanoacrılate Erdinc Eroglu 1 , Alptekin Yasım 1 , Murat Arı 2 , Hasan Ekerbıcer 3 , Aydemir Kocarslan 1 , Mehmet Kabalcı 4 and Mehmet Acıpayam 1 Abstract Aim: To present mid-term results of patients with varicose veins treated with N-butyl cyanoacrylate (VariClose Õ ), a nontumescent endovenous ablation technique. Patients and method: Endovenous ablation was performed on 180 patients with saphenous vein incompetence between May and October 2014. One hundred sixty-eight subjects capable of being followed-up for 30 months were included. Patients’ pre- and postoperative data were recorded. Results: Procedures were performed on the great saphenous vein in 159 patients and on the small saphenous vein in nine patients. Saphenous vein diameters ranged between 5.5 mm and 14 mm. Full ablation was achieved in all patients following the procedure. No complications were encountered. Patients were monitored for 30 months. Ablation rates were 100% at the 3 rd month, 98.3% at the 6 th month, 96.6% at 1 year, and 94.1% at 30 months. Mean venous clinical severity score was 10.2 before procedures, decreasing to 3.9 at 3 months, 4.2 at 6 months, 2.9 at 12 months, and 2.7 at 30 months (p ¼ 0.000). Conclusion: Due to its high success rate, absence of complications, no tumescent anesthesia requirement and high patient satisfaction, endovenous ablation with N-butyl cyanoacrylate is a good method. However, long-term follow-up results are now needed. Keywords Chronic venous disease, varicose veins, chronic venous insufficiency Introduction Endovenous ablation techniques have been widely used in the treatment of varicose veins for the last 20 years. Thermal ablation methods (particularly endovenous laser ablation (EVLA) and radiofrequency ablation (RFA) are of proven effectiveness. However, the appli- cation of tumescent anesthesia is essential in all thermal ablation methods in order to prevent tissue damage associated with high temperature. Tumescent anesthe- sia is uncomfortable for patients due to repeated injec- tions. Chemical and mechanochemical methods not requiring tumescent anesthesia have been developed in recent years in order to avoid this adverse procedure. Chemical ablation methods based on N-butyl cyano- acrylate (NBCA) are promising in terms of both effect- iveness and side-effects. NBCA has long been used in the treatment of cere- bral aneurysm and malformations in the United States, and has been approved by the FDA. 1–3 It has also been used in the treatment of various diseases, such as gastro- intestinal hemorrhages, bone cysts, corneal perforation, and cecum resection. 4–7 NBCA is widely used in the treatment of chronic venous disease. Almeida published an experimental study in 2011. 8 They later published early results for their first 38 case series. 9 In 2004, Toonder et al. 10 reported the results of 23 patients with perforator vein incompetence treated with NBCA. Studies comparing NBCA with radiofrequency ablation and laser ablation in the early period were subsequently published. 11,12 We published our early findings from 1 Faculty of Medicine, Department of Cardiovascular Surgery, Kahramanmaras Sutcu Imam University, Kahramanmaras, Turkey 2 Department of Cardiovascular Surgery, Gaziantep State Hospital, Gaziantep, Turkey 3 Faculty of Medicine, Department of Public Health, Sakarya Sutcu Imam University, Sakarya, Turkey 4 Faculty of Medicine, Department of Cardiovascular Surgery, Kirikkale University, Kirikkale, Turkey Corresponding author: Erdinc Eroglu, Faculty of Medicine, Kahramanmaras Sutcu Imam University, Kahramanmaras, Turkey. Email: erdinc046@hotmail.com Phlebology 0(0) 1–5 ! The Author(s) 2017 Reprints and permissions: sagepub.co.uk/journalsPermissions.nav DOI: 10.1177/0268355517718761 journals.sagepub.com/home/phl