下肢静脈瘤に対するシアノアクリレート系接着材による血管内治療のガイドライン

シアノアクリレート系接着材による血管内治療（cyanoacrylate closure: CAC）は，熱焼灼およびTLA麻酔を用いないnon-thermal non-tumescent（NTNT）治療の1つで，わが国では2019年にVenaSealクロージャーシステムがCACとして初めて保険認可された．本ガイドラインは，CACを安全かつ適切に施行するために，日本静脈学会ガイドライン委員会が中心となって血管内焼灼術に精通した専門医集団によって作成された．CACの適応は有症状の一次性静脈瘤であり，シアノアクリレート系接着材に対するアレルギー歴は禁忌となる．CAC特有の合併症としてシアノアクリレート...

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Published in静脈学 Vol. 31; no. 3; pp. 141 - 152
Main Authors 佐戸川, 弘之, 伊藤, 孝明, 孟, 真, 広川, 雅之, 八巻, 隆, 小野澤, 志郎, 菅野, 範英, 杉山, 悟, 保科, 克行, 八杉, 巧, 諸國, 眞太郎, 小畑, 貴司, 白杉, 望
Format Journal Article
LanguageJapanese
Published 日本静脈学会 25.12.2020
Subjects
グルー治療
シアノアクリレート
下肢静脈瘤
血管内治療
血管内焼灼術
Online AccessGet full text
ISSN0915-7395
2186-5523
DOI10.7134/phlebol.20-20

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Abstract シアノアクリレート系接着材による血管内治療（cyanoacrylate closure: CAC）は，熱焼灼およびTLA麻酔を用いないnon-thermal non-tumescent（NTNT）治療の1つで，わが国では2019年にVenaSealクロージャーシステムがCACとして初めて保険認可された．本ガイドラインは，CACを安全かつ適切に施行するために，日本静脈学会ガイドライン委員会が中心となって血管内焼灼術に精通した専門医集団によって作成された．CACの適応は有症状の一次性静脈瘤であり，シアノアクリレート系接着材に対するアレルギー歴は禁忌となる．CAC特有の合併症としてシアノアクリレートに対する遅延型過敏症あるいは異物反応による“phlebitis”が6.3%に認められる．一次性下肢静脈瘤の治療は，CACの導入によりさらに低侵襲化すると期待されるが，長期成績は不明であり，今後はエビデンス，経験の蓄積を行っていく必要がある．
AbstractList シアノアクリレート系接着材による血管内治療（cyanoacrylate closure: CAC）は，熱焼灼およびTLA麻酔を用いないnon-thermal non-tumescent（NTNT）治療の1つで，わが国では2019年にVenaSealクロージャーシステムがCACとして初めて保険認可された．本ガイドラインは，CACを安全かつ適切に施行するために，日本静脈学会ガイドライン委員会が中心となって血管内焼灼術に精通した専門医集団によって作成された．CACの適応は有症状の一次性静脈瘤であり，シアノアクリレート系接着材に対するアレルギー歴は禁忌となる．CAC特有の合併症としてシアノアクリレートに対する遅延型過敏症あるいは異物反応による“phlebitis”が6.3%に認められる．一次性下肢静脈瘤の治療は，CACの導入によりさらに低侵襲化すると期待されるが，長期成績は不明であり，今後はエビデンス，経験の蓄積を行っていく必要がある．
要約: シアノアクリレート系接着材による血管内治療(cyanoacrylate closure: CAC)は, 熱焼灼およびTLA麻酔を用いないnon-thermal non-tumescent (NTNT)治療の1つで, わが国では2019年にVenaSealクロージャーシステムがCACとして初めて保険認可された. 本ガイドラインは, CACを安全かつ適切に施行するために, 日本静脈学会ガイドライン委員会が中心となって血管内焼灼術に精通した専門医集団によって作成された. CACの適応は有症状の一次性静脈瘤であり, シアノアクリレート系接着材に対するアレルギー歴は禁忌となる. CAC特有の合併症としてシアノアクリレートに対する遅延型過敏症あるいは異物反応による"phlebitis"が6.3%に認められる. 一次性下肢静脈瘤の治療は, CACの導入によりさらに低侵襲化すると期待されるが, 長期成績は不明であり, 今後はエビデンス, 経験の蓄積を行っていく必要がある.
Author 杉山, 悟
広川, 雅之
菅野, 範英
孟, 真
小野澤, 志郎
八巻, 隆
佐戸川, 弘之
白杉, 望
小畑, 貴司
伊藤, 孝明
諸國, 眞太郎
八杉, 巧
保科, 克行
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金沢医科大学氷見市民病院胸部心臓血管外科
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福島県立医科大学心臓血管外科
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DOI 10.7134/phlebol.20-20
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– reference: 32) Tang TY, Tiwari A: The VenaSeal™ abnormal red skin reaction: looks like but is not phlebitis! Eur J Vasc Endovasc Surg 2018; 55: 841
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– reference: 41) Eroglu E, Yasim A: A randomised clinical trial comparing N-butyl cyanoacrylate, radiofrequency ablation and endovenous laser ablation for the treatment of superficial venous incompetence: two year follow up results. Eur J Vasc Endovasc Surg 2018; 56: 553–560
– reference: 38) Aalto-Korte K, Alanko K, Kuuliala O, et al: Occupational methacrylate and acrylate allergy from glues. Contact Dermat 2008; 58: 340–346
– reference: 52) Zernovicky F: Fast progressive devastating granulomatic reaction after VenaSeal procedure. Int Angiol 2018; 37: S168–S169
– reference: 2) Anwar MA, Lane TR, Davies AH, et al: Complications of radiofrequency ablation of varicose veins. Phlebology 2012; 27 Suppl. 1: 34–39
– reference: 29) Park I, Jeong MH, Park CJ, et al: Clinical features and management of “Phlebitis-like abnormal reaction” after cyanoacrylate closure for the treatment of incompetent saphenous veins. Ann Vasc Surg 2019; 55: 239–245
– reference: 30) Parsi K, Kang M, Yang A, et al: Granuloma formation following cyanoacrylate glue injection in peripheral veins and arteriovenous malformation. Phlebology 2020; 35: 115–123
– reference: 37) VenaSeal™ Closure System, Product Code: VS-402, Instruction for Use. (https://www.accessdata.fda.gov/cdrh_docs/pdf14/p140018c.pdf) （2020年5月8日閲覧）
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Snippet シアノアクリレート系接着材による血管内治療（cyanoacrylate closure: CAC）は，熱焼灼およびTLA麻酔を用いないnon-thermal non-tumescent（NTNT）治療の1つで，わが...
要約: シアノアクリレート系接着材による血管内治療(cyanoacrylate closure: CAC)は, 熱焼灼およびTLA麻酔を用いないnon-thermal non-tumescent (NTNT)治療の1つで, わが...
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jstage
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StartPage 141
SubjectTerms グルー治療
シアノアクリレート
下肢静脈瘤
血管内治療
血管内焼灼術
Title 下肢静脈瘤に対するシアノアクリレート系接着材による血管内治療のガイドライン
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