2019/5/28

第48回⽇本IVR学会総会/接着型NBCA不成功例に対する充填型NBCAの応⽤︓蛇⾏または径拡⼤のある下肢静脈瘤塞栓術への新術式

講演情報
⼀般演題静脈/リンパ管[⼀般演題14] 静脈/リンパ管
2019年5⽉31⽇(⾦) 09:00 〜 10:12

第6会場 (4F 413+414)座⻑︓太⽥ 豊裕（愛知医科⼤学 放射線医学講座）, 座⻑︓菅原 俊祐（国⽴がん研究センター中央病院 放射線診断科）[O-104] 接着型NBCA不成功例に対する充填型NBCAの応⽤︓蛇⾏または径拡⼤のある下肢静脈瘤塞栓術への新術式○榊原 直樹1, ⼋⽊ 理絵2, 今井 智浩3, 梶本 完2, 天野 篤2(1.江⼾川病院

⼼臓⾎管外科, 2.順天堂⼤学

医学部

⼼臓⾎管外科, 3.東京⾎管外科クリニック)
Introduction: Tortuous and segmentally large saphenous veins are not usually treated by thecatheter-based NBCA embolization (CAE). On the other hand, the ultrasound guided CAE(UGCE) with needle injections could be an alternative method for those patients. Thus, thisstudy addresses the efficacy of secondary filler NBCA embolization after unsuccessful adhesiveNBCA. Methods: This is a retrospective observation study of UGCE with the filler NBCA
(Histoacryl and Lipiodol by mixing ratio of 1:3) for large or tortuous saphenous veins. 45
patients (GSV/ASV 42, SSV 3) were treated with adhesive NBCA (VariClose/VenaBlock); 9 ofthem by CAE and 36 of them by UGCE. UGCE was performed in patients with vein diameter>8mm and/or segmentally large varicose sized>15mm after or in the same session of adhesive
CAE. An average age was 64.9, 24 patients (55.8%) of them were female, and 32 patients(71.1%) were >C3 disease. Mean truncal vein diameters of 7.7 mm and mean maximum veindiameters of 15.7 mm (max. 33.1) were measured. Patients were observed for three months
and assessed by anatomical/clinical success and adverse effects. Results: After the secondary
filler NBCA injection, all veins were completely occluded for three months. 6 patients showedsuperficial phlebitis but self-limited, while other adverse effects were not recorded. Clinicalsuccess was obtained by improving results from 4.5 to 2.8 with AVVQ (p<0.001), and from 5.0
to 1.8 with VCSS (p<0.001). Conclusions: Filler NBCA provided a positive effect onrecanalization after adhesive NBCA failure.

https://confit.atlas.jp/guide/print/jsir2019/subject/10063/detail?eventCode=jsir2019

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2019/5/28

第48回⽇本IVR学会総会/下肢静脈瘤に対する⾮カテーテル使⽤NBCA塞栓術の臨床的有⽤性

講演情報
⼀般演題静脈/リンパ管[⼀般演題14] 静脈/リンパ管
2019年5⽉31⽇(⾦) 09:00 〜 10:12

第6会場 (4F 413+414)座⻑︓太⽥ 豊裕（愛知医科⼤学 放射線医学講座）, 座⻑︓菅原 俊祐（国⽴がん研究センター中央病院 放射線診断科）[O-105] 下肢静脈瘤に対する⾮カテーテル使⽤NBCA塞栓術の臨床的有⽤性○榊原 直樹1, ⼋⽊ 理絵2, 今井 智浩3, 梶本 完2, 天野 篤2(1.江⼾川病院

⼼臓⾎管外科, 2.順天堂⼤学医学部

⼼臓⾎管外科, 3.東京⾎管外科クリニック)
Introduction: Tortuosity or large truncal varicosity would be commonly contraindicated for acatheter-based NBCA embolization (CCAE) for saphenous vein reflux. To overcome thisdifficulty, a no catheter-based technique; ultrasound guided NBCA embolization (UGCE), would
be an alternative method. This study addresses the efficacy of UGCE compared with CCAE in
the real world. Methods: This is the retrospective, observation study of NBCA embolization forincompetent saphenous veins (n=292) with CCAE (n=220) or UGCE (n=72). Of the 256
patients, the average age was 64.8, 196 patients (67.1%) were female, and 171 patients(66.8%) were ≧C3 disease. A mean truncal vein diameter of 7.1 mm and the largest veindiameter of 13.3 mm (max. 33.1) were measured. All legs were treated mainly with adhesiveNBCAs; 220 legs by CCAE and 72 legs by UGCE. Patients were observed over a period up toone year. Results: Several NBCAs were used for 262 of GSV/ASVs and 31 of SSVs; VariClose for
260 legs, VenaBlock for 15 legs, VenaSeal for 4 legs, Endosealer/Veinoff for 2 legs. A mean
NBCA volumes per session were 2.0±1.5 mL with CCAE and 2.4±1.1 mL with UGCE. Superficialphlebitis was recorded in 27 legs (12.3%) and 4 legs (5.1%) respectively, while other adverse
effects were minimal. The largest diameters were reduced with both procedures. Anatomical
failure was observed in 19 legs (8.6 %) and 4 legs (5.1%) respectively, however VCSS wassignificantly improved with both procedures. Conclusions: UGCE showed no inferiority to CCAE
in the real world. UGCE would be recommended for unaccessible veins.

https://confit.atlas.jp/guide/print/jsir2019/subject/10066/detail?eventCode=jsir2019&eventCode=jsir2019

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