Clinical Outcomes of Cyanoacrylate Closure Versus Radiofrequency Ablation for Saphenous Varicose Veins: A Single‐Center Retrospective Study

<b>Introduction:</b> Varicose veins are a common condition affecting millions worldwide. Cyanoacrylate closure (CAC) and radiofrequency ablation (RFA) are widely used minimally invasive treatments. CAC offers advantages such as eliminating tumescent local anesthesia (TLA) and reducing nerve injury risk. However, there are few reports comparing CAC and RFA outcomes in Japan. This study is aimed at evaluating the efficacy and safety of CAC and RFA for treating great saphenous vein (GSV) and small saphenous vein (SSV) varicose veins. <b>Materials and Methods:</b> A retrospective, single-center study was conducted with 157 patients (178 limbs) who underwent either CAC (<i>n</i> = 96) or RFA (<i>n</i> = 82) from January 2020 to October 2023. Postoperative occlusion rates, complications, and risk factors for phlebitis were analyzed. Follow-up ultrasound examinations were conducted at up to 3 months postoperatively. Statistical analyses included <i>t</i>-tests, Mann-Whitney <i>U</i> tests, and multivariate logistic regression. <b>Results:</b> Both CAC and RFA achieved a 100% occlusion rate at 3 months. In the CAC group, significantly longer vein segments were treated compared to those in the RFA group (46 ± 14 cm vs. 35 ± 13 cm, <i>p</i> < 0.05). However, phlebitis occurred in 15% of the CAC group, whereas none were reported in the RFA group (<i>p</i> < 0.05). Multivariate analysis identified preoperative swelling (OR: 5.60, 95% CI: 1.33-23.6, <i>p</i> < 0.05) and treated vein length as independent risk factors for phlebitis. All phlebitis cases resolved with conservative treatment. One patient in the RFA group experienced transient paresthesia. <b>Conclusion:</b> CAC is a viable alternative to RFA, demonstrated equivalent occlusion rates, though CAC exhibited a higher incidence of phlebitis. Careful patient selection and perioperative management may help mitigate risks. Further studies with larger cohorts and longer follow-up are needed to optimize treatment protocols and long-term outcomes.