Recurrent Systemic Urticaria Following Cyanoacrylate Closure for the Treatment of Incompetent Saphenous Veins

Urticaria Cyanoacrylates Varicose veinsThe VenaSeal (Medtronic) cyanoacrylate closure system is a non-thermal non-tumescent technique for ablating saphenous veins using a proprietary n-butyl cyanoacrylate.A potential side effect is an allergic reaction to the cyanoacrylate.It is widely known that most reactions occur locally around the saphenous vein at the site of the procedure, while systemic allergic reactions are exceedingly rare.We present the case of a 31-yearold woman who was treated with cyanoacrylate closure and subsequently developed recurrent systemic urticaria.There were no notable issues until one week after the procedure, but on postoperative day (POD) 8, itching and swelling accompanied by a rash appeared at the site of the procedure, with the rash spreading to the abdomen.Following this, a whole body rash and wheezing occurred.While symptoms improved with the use of steroids and antihistamines, the systemic rash intermittently reappeared after discontinuation of the medication.