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The Cause of Abnormal Skin Findings after Ultrasound-Guided Injection of Cyanoacrylate Glue in an Animal Model
J Surg Ultrasound 2020;7:42-46
Published online November 30, 2020;  https://doi.org/10.46268/jsu.2020.7.2.42
© 2020 The Korean Surgical Ultrasound Society

Soo Yeon Chung, Sungsin Cho, Jin Hyun Joh

Department of Surgery, Kyung Hee University Hospital at Gangdong, Kyung Hee University School of Medicine, Seoul, Korea
Correspondence to: Jin Hyun Joh
Department of Surgery, Kyung Hee University Hospital at Gangdong, Kyung Hee University School of Medicine, 892 Dongnam-ro, Gangdong-gu, Seoul 05278, Korea
Tel.: +82-2-440-6261
Fax: +82-2-440-6296
E-mail: jhjoh@khu.ac.kr
Received October 25, 2020; Revised November 11, 2020; Accepted November 15, 2020.
Journal of Surgical Ultrasound is an Open Access Journal. All articles are distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/4.0/) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.
Abstract
Purpose: Cyanoacrylate closure has been recently introduced as a non-thermal method for the treatment of varicose veins. An abnormal skin finding can be an extremely worrisome complication after a cyanoacrylate closure. This study aimed at identifying if joint movement could be a possible cause for this reaction using a pig model.
Methods: The pigs were administered general anesthesia and monitored by a veterinarian. After aseptic preparation, the cyanoacrylate glue was injected into the leg vein through a delivery catheter, or into the ear vein through a 22G needle. The pigs were divided into 2 groups according to the involvement of the joints, with the injected glue. Ten days after the glue was injected, the veins were harvested, and pathologic findings were analysed.
Results: We obtained 6 vein specimens with the surrounding tissue. Both the groups, involving the joint, and not involving the joint included one leg vein and 2 ear veins. The pathologic finding in the group not involving the joint showed that inflammatory cells (mainly lymphocytes) infiltrated the vein wall. In the group involving the joints, the same inflammatory cells infiltrated both the vein wall and surrounding tissue.
Conclusion: In this animal study, the injected glue triggered an inflammatory reaction. When the glue was injected across a joint, an inflammatory reaction developed in the vein wall as well as the surrounding tissue. It may be assumed that cyanoacrylate glue injected during closure of the vein can result in an abnormal skin finding if there is an active movement of the joint involved.
Keywords : Varicose veins, Cyanoacrylates, Inflammation, Lymphocyte, Pathology


November 2020, 7 (2)