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Case Reports
. 2019 Aug 7;5(3):372-374.
doi: 10.1016/j.jvscit.2019.05.004. eCollection 2019 Sep.

Persistent type IV hypersensitivity after cyanoacrylate closure of the great saphenous vein

Andrew D Jones  1 , Edward M Boyle  1 , Randy Woltjer  2 , Jason P Jundt  3 , Adam N Williams  4
Affiliations
Case Reports

Persistent type IV hypersensitivity after cyanoacrylate closure of the great saphenous vein

Andrew D Jones et al. J Vasc Surg Cases Innov Tech. .

Abstract

The VenaSeal (Medtronic, Minneapolis, Minn) cyanoacrylate closure system is a nonthermal technique for ablating saphenous veins using a proprietary n-butyl cyanoacrylate. One possible side effect is an allergic reaction to cyanoacrylate. We report the case of a 49-year-old woman treated with cyanoacrylate closure who developed a persistent type IV hypersensitivity reaction. The patient elected to have the vein excised, and the histologic features were consistent with a type IV hypersensitivity reaction.

Keywords: Allergic reaction; Endovenous ablation; Hypersensitivity; Varicose vein; VenaSeal.

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Figures

Fig 1
Fig 1
Excised great saphenous vein (GSV) with intraluminal foreign body.
Fig 2
Fig 2
Histopathologic evaluation of the removed saphenous vein. A, Low-magnification view showing vein with intraluminal foreign material (*) and dense chronic inflammation (#) that was localized to the luminal aspect of the vessel with relative preservation of the periphery. B, Higher magnification view shows intraluminal material (*), some of which is present in the vessel wall within foreign body giant cell macrophages. Small lymphocytes (#) that type predominantly as T4 lymphocytes contribute to the granulomatous inflammation. C, The endothelial surface associated with the intraluminal material (*) shows vacuoles characteristic of injury and with subendothelial histiocytes and reactive fibroblasts (#).
See this image and copyright information in PMC

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