In a new interventional procedures guidance, the National Institute for Health and Care Excellence (NICE) has recommended cyanoacrylate glue occlusion for the treatment of varicose veins.
The procedure involves injecting cyanoacrylate, a medical glue into the varicose veins to close the veins by adherence, followed by fibrosis of the lumen. The procedure eliminates the need for tumescent anaesthesia and reduces the requirement of post-operative compression therapy. Cyanoacrylate glue occlusion should be exclusively performed by clinicians who are appropriately trained in the procedure and have experience in using venous ultrasound.
Current interventional options for varicose veins include endothermal ablation (radiofrequency ablation and endovenous laser ablation therapy), foam sclerotherapy, mechanochemical ablation and surgery (stripping and ligation of saphenous veins, and phlebectomy).
NICE has stated that cyanoacrylate glue occlusion demonstrates adequate safety and efficacy to support its routine use within the NHS, provided standard arrangements for clinical governance, consent and audit are in place.