Venaseal
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VenaSeal™
is the brand name for a form of ‘superglue’, chemically called cyanoacrylate, which is used in the treatment of varicose veins.
It was originally formulated by a called Sapheon, but they have now sold the Venaseal brand to a larger company called Medtronic. Venaseal is not the only ‘vein glue’ available on the market.
bears a lot of similarities to the superglue you can buy in many shops to use in your own home. However, it has been modified so that it can be used in medical practice. This is it needs to be used within a vein and so does not set quite as as the commercial glue . Therefore, when it has been used in a vein, you do not feel a rigid tube in your leg. Summary
Cyanoacrylate glue is a glue that is good at gluing biological tissue .
Anyone who has ever used superglue at home, and has accidentally glued their together, knows quite how good it is gluing skin! (Do not try this at home!)
In the very early days of cyanoacrylate, were done gluing different types of human tissue together including in liver surgery, and in skin incisions to avoid using . However, because the market for selling glue products to use at home was bigger, most of the production went into superglue commercial sale, rather than in medical applications.
However, there have still been some uses for glue in medicine and which have been used for many years.
was by Dr. Rob Rabe, an radiologist in America. He used a similar glue to block off vessels that were bleeding, in the case of brain . He realised that if you could block off these high pressure by injecting a glue down a very thin cannula, under x-ray control, then there was no reason you could not do this in bigger vessels such as varicose veins.
He then developed the polymer, which is a liquid/gel when injected into the vein and then when in contact with fluid. He had to a compound of cyanoacrylate that was not rigid so that the vein did not feel like a "rod" in the leg whilst it was healing.
There have been a lot of research studies looking for any effects of the cyanoacrylate glue in the body, but none have been found in humans. It appears to be very safe when used correctly by specialists who perform a lot of treatments, i.e. who treat vein .
As with all endovenous surgery for varicose veins nowadays, Venaseal is performed as a walk-in, walk-out, local anaesthetic .
Having previously had your veins diagnosed you would visit a specialist clinic for to address the cause. Once out of your closes into gowns, you will lie on the operating couch and the couch is tipped head up to fill the veins up in your legs. A technologist marks where the main veins lie under the skin, using ultrasound, and then you stand OnabotulinumtoxinAAbobotulinumtoxinAIncobotulinumtoxinAPrabotulinumtoxinALetibotulinumtoxinARimabotulinumtoxinBHyaluronic Acid FillersCalcium Hydroxylapatite FillersPoly-L-lactic Acid FillersPolymethylmethacrylate FillersAutologous Fat GraftingForehead Lines TreatmentGlabellar Frown Lines TreatmentCrow's Feet TreatmentBunny Lines TreatmentChemical Brow LiftLip FlipGummy Smile CorrectionMasseter ReductionJaw SlimmingDimpled Chin SmoothingCobblestone Chin SmoothingNefertiti Neck LiftMicro-BotoxMesotoxHyperhidrosis TreatmentChronic Migraine ReliefBruxism TreatmentTMJ TreatmentCervical Dystonia TreatmentNeck Spasm TreatmentBlepharospasm TreatmentLip AugmentationLip ContouringCheekbone EnhancementTear Trough FillersNasolabial Fold SofteningMarionette Line FillersLiquid RhinoplastyNon-Surgical Nose JobJawline ContouringJawline DefinitionChin AugmentationTemple VolumisingHand RejuvenationAcne Scar Subcision Filling up whilst the veins on the surface are marked.
You will then lie back on the couch and your leg is with fluid. sheets are placed around you and your leg. One local is then performed somewhere usually just above or below the knee. Under ultrasound guidance, a needle is passed into the vein. A wire is then passed up this needle, and the needle removed, leaving the wire in the position within the vein. Using this wire, a thin tube or is passed up the vein, again under control so the practitioner can see where it is going. It is placed just short of the top of the vein where it joins the deep vein.
The operating couch is then tipped head down to empty the vein of all blood. Pressure is applied to the top of the vein with the ultrasound tip. The surgeon a set amount of the Venaseal glue and pulls back the . A period of time (usually three minutes) is then waited whilst the glue sets. This is important as this glues the vein shut.
The surgeon then injects a further set amount of glue, pulls the back 3cm and waits another 30 seconds for the glue to start to set. This is continued for the whole length of vein that needs to be . Once the vein has been completely glued through the whole length, the is removed and a little plaster is placed over the where the operation took place.
The use of Venaseal in an operation can be with other procedures, such as sclerotherapy, which may need to be done on other veins in the leg(s) during the same operating session, depending on the vascular problems that you have.
Your leg is usually placed in a support stocking and you will be asked to get up to walk about immediately (with assistance if required).
Venaseal glue should be used to close refluxing veins such as the great saphenous vein, small saphenous vein and vein. Recent have also said it can be used for incompetent veins using the TRLOP (TRansLuminal of Perforators) technique.
It is not used for (varicose) veins on the or for thread veins, although it might be used to treat the underlying veins which are causing such surface problems. It also might be used to cure the underlying veins causing venous eczema, legs, brown around the ankles (haemosiderin) and leg ulcers.
It is important to note as with all endovenous (inside the vein) such as , , TRLOP and MOCA (Mechanical and Assistance), e.g. , that all of these techniques treat the refluxing veins (which are deeper inside the body) that cause things such as varicose veins, thread veins and skin damage that can be seen on the surface. They are not treatments for the varicose veins themselves, but they are essential to be used as part of the treatment for varicose veins and these other visible .
Medical Device
As with all endovenous surgery including endovenous laser ablation, radiofrequency ablation, guided foam sclerotherapy, TRLOP and MOCA, should be used by teams of vein specialists as outlined in the
The consultant in charge of the team may be a vascular surgeon, general surgeon, radiologist or occasionally a dermatologist but they will need to have a specialist of .
They should work as part of a team that include specialists that do the duplex ultrasound examinations to ensure diagnosis of the vein problem and safe and placement of the within the vein.
The NICE guidelines point out that this should always be performed as part of a team - although some doctors and clinics try to save money by having one doctor seeing the patient, doing their own scan and then doing the operation, this has been shown to reduce accuracy and therefore is not recommended by the NICE .
Venaseal glue should not be used in surface veins where it might cause lumps that can be felt through the skin. It should also not be used in very large veins until research has been done to show that this is safe. It is probably less effective in veins that have had clot in them although once again, research is required to see if this is the case.
If this is performed by surgeons working as part of a team as by NICE CG168, then a is very rare.
Research studies that have been done so far seem to indicate that the glue sticks the vein together in the first instance, but in the long term, the vein wall is permanently destroyed by what is called a "foreign body reaction". Once this has occurred, it is unlikely the vein will ever reopen in future.
Approximately one or two in every 10 people will suffer from "phlebitis" which is a painful red swelling running along the course of the treated vein. This occurs when there is a severe action due to the vein being destroyed by the glue. It can also happen when veins that usually have blood flow into or out of the treated vein can become inflamed with phlebitis.
Sometimes, particularly with less experienced surgeons, or those without someone else doing the ultrasound scan whilst they are doing the procedure, the end of the catheter might not be precisely aligned and some of the glue might land into the deep vein. This looks like a very worrying on the ultrasound, although it is probably not clinically . There have not been any reports so far of this causing a problem.
Although this is a very good system to reduce the number of needed to treat the veins, if there are big veins on the surface, they still need to be removed and so a lot of the is lost. has the in patients who do not like injections, but need to have underlying vein reflux when on the they have thread veins, small or very veins, ankle swelling due to venous reflux but without veins, venous eczema due to venous reflux but without visible varicose veins, or leg ulcers due to venous reflux but without visible varicose veins.
is currently considerably more expensive than the more endovenous laser ablation or procedures.
When in the appropriate and correctly, the results should be the same with any of these three techniques. Therefore, in patients, you will need to decide whether the extra cost of it is worth the in the requirement to inject tumescent around the vein in locations, which is needed in endovenous laser ablation and radiofrequency ablation procedures. is less in that .
Because of the cost, it is unlikely that health insurance or the NHS are likely to fund a procedure, although they may well do so in cases if a strong enough is made.
Expect to pay approximately £4,000 for treating one leg or £5,000 for treating both.
There has been a long-term study of which Professor Mark Whiteley was part of, looking at the efficacy of Venaseal in who had varicose veins due to great vein reflux, when the great saphenous vein was 10mm or less in .
Several different vein centres around Europe were included and these patients have now been followed up for three years. The results have been excellent and have been reported in several meetings. In addition, a randomised study published in 2015 (VeClose study) showed that in the short term, glue and radiofrequency ablation success rates were almost identical. A further study called the WAVES study reported that in treating the small vein or the saphenous vein was also .
As such the Venaseal for the treatment of great saphenous vein, small saphenous vein and anterior accessory saphenous vein appears to be in technical rates to laser and .
courtesy of The Clinic and Venaseal™
(All before and after photographs are real patients, your results may differ).
Before and After Venaseal™ Treatment
Before and After Venaseal™ Treatment
Before and After Venaseal™ Treatment
We would like to thank Vascular Surgeon Professor Mark Whiteley from for his expert help with this FAQ.
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