asurgeryАмбулаторная хирургияAmbulatornaya khirurgiya = Ambulatory Surgery (Russia)2712-87412782-2591ООО «ГРУППА РЕМЕДИУМ»10.21518/akh2026-001asurgery-600Research ArticleФЛЕБОЛОГИЯPHLEBOLOGYФлебит после цианоакрилатной облитерации вен: современное состояние проблемыPhlebitis after cyanoacrylate obliteration: Modern state of the problemhttps://orcid.org/0009-0006-9211-4671НадвиковА. И.NadvikovA. I.

Надвиков Алексей Игоревич, врач – сердечно-сосудистый хирург

297412, Республика Крым, Евпатория, проспект Ленина, д. 56А, пом. 7

Alexey I. Nadvikov, Cardiovascular Surgeon

56A, Room 7, Lenin Ave., Evpatoria, Republic of Crimea, 297412

nadvikov-a@mail.ruhttps://orcid.org/0009-0005-3594-3433КозловаВ. В.KozlovaV. V.

Козлова Валерия Владимировна, студент

117997, Москва, ул. Островитянова, д. 1

Valeriya V. Kozlova, Student

1, Ostrovityanov St., Moscow, 117997

v.v.kozlova25@gmail.comhttps://orcid.org/0000-0001-5411-6437ФокинА. А.FokinA. A.

Фокин Алексей Анатольевич, д.м.н., профессор, заведующий кафедрой хирургии факультета послевузовского и дополнительного профессионального образования Института дополнительного профессионального образования

454092, Челябинск, ул. Воровского, д. 64

Alexey A. Fokin, Dr. Sci. (Med.), Professor, Head of the Department of Surgery, Faculty of Postgraduate and Additional Education, Institute of Additional Professional Educational

64, Vorovskiy St., Chelyabinsk, 454092

alanfokin@yandex.ruhttps://orcid.org/0009-0000-5405-0511ГасниковА. В.GasnikovA. V.

Гасников Анатолий Владимирович, к.м.н., врач – сердечно-сосудистый хирург

297412, Республика Крым, Евпатория, проспект Ленина, д. 56А, пом. 7

Anatoliy V. Gasnikov, Cand. Sci. (Med.), Cardiovascular Surgeon

56A, Room 7, Lenin Ave., Evpatoria, Republic of Crimea, 297412

gas-nik@mail.ruhttps://orcid.org/0009-0002-9300-1805ЧерноусовВ. В.ChernousovV. V.

Черноусов Вадим Владимирович, врач – сердечно-сосудистый хирург

297412, Республика Крым, Евпатория, проспект Ленина, д. 56А, пом. 7

Vadim V. Chernousov, Cardiovascular Surgeon

56A, Room 7, Lenin Ave., Evpatoria, Republic of Crimea, 297412

cranion03@yandex.ruhttps://orcid.org/0009-0006-0842-757XХисамутдиновД. А.KhisamutinovD. A.

Хисамутдинов Денис Альфатович, врач – сердечно-сосудистый хирург

297412, Республика Крым, Евпатория, проспект Ленина, д. 56А, пом. 7

Denis A. Khisamutinov, Cardiovascular Surgeon

56A, Room 7, Lenin Ave., Evpatoria, Republic of Crimea, 297412

luftant@gmail.comhttps://orcid.org/0000-0002-5358-7218ЛобастовК. В.LobastovK. V.

Лобастов Кирилл Викторович, д.м.н., профессор кафедры общей хирургии имени В.М. Буянова Института хирургии

117997, Москва, ул. Островитянова, д. 1

Kirill V. Lobastov, Dr. Sci. (Med.), Professor of the Department of General Surgery named after V.M. Buyanov

1, Ostrovityanov St., Moscow, 117997

lobastov_kv@mail.ruСпециализированная клиника инновационной флебологии «СКИФ»РоссияSpecialized Clinic of Innovative Phlebology “SKIF”Russian FederationРоссийский национальный исследовательский медицинский университет имени Н.И. ПироговаРоссияPirogov Russian National Research Medical UniversityRussian FederationЮжно-Уральский государственный медицинский университетРоссияSouth Ural State Medical UniversityRussian Federation2026070620262314053Copyright © Надвиков А.И., Козлова В.В., Фокин А.А., Гасников А.В., Черноусов В.В., Хисамутдинов Д.А., Лобастов К.В., 20262026Надвиков А.И., Козлова В.В., Фокин А.А., Гасников А.В., Черноусов В.В., Хисамутдинов Д.А., Лобастов К.В.Nadvikov A.I., Kozlova V.V., Fokin A.A., Gasnikov A.V., Chernousov V.V., Khisamutinov D.A., Lobastov K.V.Данная работа распространяется под лицензией Creative Commons Attribution 4.0.This work is licensed under a Creative Commons Attribution 4.0 License.https://www.a-surgeon.ru/jour/article/view/600

Флебит является специфическим и распространенным осложнением цианоакрилатной облитерации (ЦАО) вен, однако его точное определение, механизмы развития, частота встречаемости и общепринятый подход к лечению до сих пор отсутствуют. Целью данного обзора явилась оценка частоты возникновения флебита целевой вены после ЦАО поверхностных вен при варикозной болезни нижних конечностей (ВБНК) – цианоакрилатного флебита (ЦАФ), а также изучение подходов к диагностике и лечению данного осложнения. В марте 2025 г. был проведен систематический поиск и отбор литературы в базе данных PubMed, включавший оригинальные исследования с участием пациентов с ВБНК, которым была выполнена ЦАО, с сообщением о частоте развития ЦАФ в послеоперационном периоде. Первичной конечной точкой анализа являлось наличие подтвержденного флебита и/или флебитоподобной реакции со стороны целевой вены в соответствии с критериями оригинального исследования. Полученные данные были обобщены с использованием модели случайного эффекта. В соответствии со сформулированным поисковым запросом обнаружено 114 ссылок, из которых в анализ включены 24 полнотекстовые статьи, содержащие данные о результатах 27 362 ЦАО. Дополнительно включены данные собственного исследования по применению оригинальной цианоакрилатной композиции по методике «ВАКОВ» у 53 пациентов. По результатам метааналитического обобщения частота развития ЦАФ составила 11% (95% ДИ: 7–14%, гетерогенность: p < 0,0001; I2 = 92,4%). Анализ подгрупп в зависимости от методики клеевой облитерации продемонстрировал достоверные различия по частоте развития ЦАФ при использовании технологий VariClose (Турция), VenaBlock (Турция) и VenaSeal (США): 4% (95% ДИ: 2–6%), 3% (95% ДИ: 0–5%) и 16% (95% ДИ: 11–21%) соответственно (p < 0,0001). Боль по ходу облитерированной вены, болезненность при пальпации, гиперемия и отек чаще всего встречались в качестве клинических проявлений флебита. Лечение ЦАФ отличалось высокой гетерогенностью и включало использование нестероидных противовоспалительных средств, антигистаминных препаратов, глюкокортикоидов и антибиотиков. ЦАФ представляет собой частое специфическое осложнение ЦАО, встречающееся с частотой около 11%, при отсутствии однозначных критериев диагностики, а также единых подходов к лечению и профилактике.

Phlebitis is a specific and widespread complication of cyanoacrylate obliteration (CAO). However, the definition, mechanisms of development, the incidence, and common treatment methods, have not been clarified. The study aimed to evaluate the incidence of phlebitis in a treated vein after CAO of varicose veins (VV) of the lower limbs and explore approaches for diagnosis and treatment of the latter complication. In March 2025, a systematic search for relevant papers was performed in PubMed, which included original studies with data about patients with VVs who underwent CAO and reported the incidence of post-procedure cyanoacrylate phlebitis (CAP). The primary endpoint was the presence of confirmed phlebitis and/or a phlebitis-like reaction in treated veins according to the original study criteria. Extracted data were summarized with a random effects model. A literature search identified 114 references, of which 24 full-text studies reporting 27,362 interventions were included in the analysis. Additionally, data from our study about the use of the original cyanoacrylate composition with “VACOV” technique in 53 patients were included. The incidence of CAP was 11% (95% CI: 7–14%; p < 0.001, I2 = 92.4%). The subgroup analysis according to methods of glue embolization revealed significant differences in CAP incidence with VariClose (Turkey), VenaBlock (Turkey) and VenaSeal (USA): 4% (95% CI: 2–6%), 3% (95% CI: 0–5%), and 16% (95% CI: 11–21%), respectively (p < 0.001). Pain along the treated vein, palpatory tenderness, hyperemia, and swelling were the most common clinical manifestations of phlebitis. The treatment of CAP was heterogeneous and included as follows: nonsteroidal anti-inflammatory drugs, antihistamines, glucocorticoids, and antibiotics. CAP is a frequent specific complication of CAO with an incidence of 11% without defined diagnostic criteria and common treatment and prophylaxis approaches.

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The authors declare that there are no conflicts of interest present.