A Case of Decannulating Incompetent Great Saphenous Vein Filling Cyanoacrylate because of Type IV Hypersensitivity
Cyanoacrylate closure for the treatment of incompetent great saphenous vein have accepted as insurance coverage in Japan. This treatment is non-thermal and non-tumescent technique. However, there are some cases develop postoperative complication. We describe allergic-like reaction caused by cyanoacr...
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| Published in | Japanese Journal of Vascular Surgery Vol. 31; no. 3; pp. 123 - 127 |
|---|---|
| Main Authors | , , |
| Format | Journal Article |
| Language | Japanese |
| Published |
JAPANESE SOCIETY FOR VASCULAR SURGERY
31.05.2022
特定非営利活動法人 日本血管外科学会 |
| Subjects | |
| Online Access | Get full text |
| ISSN | 0918-6778 1881-767X |
| DOI | 10.11401/jsvs.22-00007 |
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| Abstract | Cyanoacrylate closure for the treatment of incompetent great saphenous vein have accepted as insurance coverage in Japan. This treatment is non-thermal and non-tumescent technique. However, there are some cases develop postoperative complication. We describe allergic-like reaction caused by cyanoacrylate closure for the treatment of incompetent great saphenous vein. A 79-years-old woman had this treatment, developed swelling of diseased side leg seven days after the treatment. We suspected that there was some kind of allergic reaction. This case got a DLST, and the result was positive. We diagnosed this case as type IV hypersensitivity, administered drugs. But, the symptoms were not improved. As a result, we decannulate left saphenous vein filling CA. |
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| AbstractList | Cyanoacrylate closure for the treatment of incompetent great saphenous vein have accepted as insurance coverage in Japan. This treatment is non-thermal and non-tumescent technique. However, there are some cases develop postoperative complication. We describe allergic-like reaction caused by cyanoacrylate closure for the treatment of incompetent great saphenous vein. A 79-years-old woman had this treatment, developed swelling of diseased side leg seven days after the treatment. We suspected that there was some kind of allergic reaction. This case got a DLST, and the result was positive. We diagnosed this case as type IV hypersensitivity, administered drugs. But, the symptoms were not improved. As a result, we decannulate left saphenous vein filling CA. Cyanoacrylate closure for the treatment of incompetent great saphenous vein have accepted as insurance coverage in Japan. This treatment is non-thermal and non-tumescent technique. However, there are some cases develop postoperative complication. We describe allergic-like reaction caused by cyanoacrylate closure for the treatment of incompetent great saphenous vein. A 79-years-old woman had this treatment, developed swelling of diseased side leg seven days after the treatment. We suspected that there was some kind of allergic reaction. This case got a DLST, and the result was positive. We diagnosed this case as type IV hypersensitivity, administered drugs. But, the symptoms were not improved. As a result, we decannulate left saphenous vein filling CA. 本邦において下肢静脈瘤に対するシアノアクリレート血管内塞栓術（以下，CAC）が2019年12月から保険適用となり，全国的に症例数が増加している．しかしながら，新しい治療法であることから合併症などについてはまだデータの蓄積が必要な段階である．特に塞栓された静脈に対する炎症所見については，その原因も含めまだまだ議論がなされるところである．われわれはCAC後にアレルギー様症状を呈した症例に対し薬剤誘発性リンパ球刺激試験（以下DLST）を施行した．その結果，陽性を示し投薬による症状コントロールが困難なためCAC充填静脈の全抜去に至った症例を経験したため報告する． |
| Author | Nakayama, Mayuko Suzuki, Hiroyuki Wada, Hideichi |
| Author_FL | 中山 真悠子 鈴木 博之 和田 秀一 |
| Author_FL_xml | – sequence: 1 fullname: 中山 真悠子 – sequence: 2 fullname: 鈴木 博之 – sequence: 3 fullname: 和田 秀一 |
| Author_xml | – sequence: 1 fullname: Suzuki, Hiroyuki organization: Department of Vascular Surgery, Kashiwa Kousei General Hospital – sequence: 1 fullname: Nakayama, Mayuko organization: Department of Vascular Surgery, Kashiwa Kousei General Hospital – sequence: 1 fullname: Wada, Hideichi organization: Department of Cardiovascular Surgery, Fukuoka University |
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| Copyright | 2022 The Japanese Society for Vascular Surgery |
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| DocumentTitle_FL | 下肢静脈瘤シアノアクリレート血管内塞栓術後の遅発型アレルギーによりグルー充填静脈全抜去に至った一例 |
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| PublicationTitle | Japanese Journal of Vascular Surgery |
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| References | 1) Morrison N, Gibson K, McEnroe S, et al. Randomized trial comparing cyanoacrylate embolization and radiofrequency ablation for incompetent great saphenous veins (VeClose). J Vasc Surg 2015; 61: 985–994. 8) Jones AD, Boyle EM, Woltjer R, et al. Persistent type IV hypersensitivity after cyanoacrylate closure of the great saphenous vein. J Vasc Surg Cases Innov Tech 2019; 5: 372–374. 6) Pichler WJ, Tilch J. The lymphocyte transformation test in the diagnosis of drug hypersensitivity. Allergy 2004; 59: 809–820. 3) Gibson K, Ferris B. Cyanoacrylate closure of incompetent great, small and accessory saphenous veins without the use of post-procedure compaserrion: initial outcomes of a post-market evaluation of the VenaSeal System (the WAVES Study). Vascular 2017; 25: 149–156. 5) 広川雅之，佐戸川弘之，八杉 巧，他．下肢静脈瘤に対するシアノアクリレート系接着剤による血管内治療のガイドライン．静脈学2020; 31: 141–152. 7) 北見啓之，山口毅一．リンパ球を用いた薬剤アレルギーの診断．臨床免疫1983; 15: 727–736. 4) 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. 2) Lawson J, Gauw S, Van Vlijmen C, et al. Saphenon: the solution? Phlebology 2013; 28 Suppl 1: 2–9. |
| References_xml | – reference: 8) Jones AD, Boyle EM, Woltjer R, et al. Persistent type IV hypersensitivity after cyanoacrylate closure of the great saphenous vein. J Vasc Surg Cases Innov Tech 2019; 5: 372–374. – reference: 2) Lawson J, Gauw S, Van Vlijmen C, et al. Saphenon: the solution? Phlebology 2013; 28 Suppl 1: 2–9. – reference: 5) 広川雅之，佐戸川弘之，八杉 巧，他．下肢静脈瘤に対するシアノアクリレート系接着剤による血管内治療のガイドライン．静脈学2020; 31: 141–152. – reference: 6) Pichler WJ, Tilch J. The lymphocyte transformation test in the diagnosis of drug hypersensitivity. Allergy 2004; 59: 809–820. – reference: 7) 北見啓之，山口毅一．リンパ球を用いた薬剤アレルギーの診断．臨床免疫1983; 15: 727–736. – reference: 3) Gibson K, Ferris B. Cyanoacrylate closure of incompetent great, small and accessory saphenous veins without the use of post-procedure compaserrion: initial outcomes of a post-market evaluation of the VenaSeal System (the WAVES Study). Vascular 2017; 25: 149–156. – reference: 4) 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: 1) Morrison N, Gibson K, McEnroe S, et al. Randomized trial comparing cyanoacrylate embolization and radiofrequency ablation for incompetent great saphenous veins (VeClose). J Vasc Surg 2015; 61: 985–994. |
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| SubjectTerms | allergic-like reaction cyanoacrylate closure DLST endovenous technique side effects シアノアクリレート血管内塞栓術 下肢静脈瘤 薬剤誘発性リンパ球刺激試験 遅発型アレルギー 静脈炎 |
| Title | A Case of Decannulating Incompetent Great Saphenous Vein Filling Cyanoacrylate because of Type IV Hypersensitivity |
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