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Phlebologie 2020; 49(04): 211-216
DOI: 10.1055/a-1186-3746
Review

NTNT Methods – Efficacy and Safety Issue

NTNT-Methoden – Wirksamkeits- und Sicherheitsaspekte
Aleksandra Jaworucka-Kaczorowska
  Jaworuccy Surgery Center, Center of Phlebology and Aesthetic Medicine
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Abstract

The management of elimination of the pathological reflux in the saphenous vein has been developed recently by introducing the endovenous thermal techniques (EVTA), which have become the first line treatment. However, thermal techniques require tumescent infiltration, what may be the cause of discomfort. Furthermore, the use of EVTA has a potential risk of thermal damage of superficial nerves and requires to wear stocking after the procedure.

Non-thermal non-tumescent techniques (NTNT) were proposed as a valid, safe and effective alternative to EVTA with significant clinical improvement, high complete occlusion rate and high posttreatment patient satisfaction. The most common novel NTNT are catheter-directed cyanoacrylate adhesive closure (CAC) and mechanochemical ablation.

In the paper an overview of the currently available data regarding the NTNT efficacy and safety are presented.

Based on the literature, NTNT has a high efficacy, comparable with the EVTA techniques, with an acceptable risk increase. However further studies with long-term results are needed also with regard to safety aspects.

Zusammenfassung

In jüngster Zeit hat die Behandlung zur Beseitigung eines pathologischen V.-saphena-Reflux mit Einführung der endovenösen thermischen Ablationstechniken (EVTA), die inzwischen die Erstlinientherapie darstellen, Fortschritte gemacht. Die thermischen Techniken erfordern jedoch eine Tumeszenz-Infiltration, die Beschwerden verursachen kann. Auch geht die Anwendung der EVTA mit einem potenziellen Risiko für eine thermische Schädigung der superfiziellen Nerven einher und erfordert das Tragen von Kompressionsstrümpfen nach dem Eingriff.

Nichtthermische Techniken ohne Tumeszenz (NTNT, non-thermal non-tumescent) wurden als geeignete, sichere und wirksame Alternative zu EVTA mit deutlicher klinischer Besserung, hoher vollständiger Verschlussrate und hoher posttherapeutischer Patientenzufriedenheit vorgeschlagen. Die gängigsten modernen NTNT-Verfahren sind der Katheter-gestützte Verschluss mittels Cyanacrylatkleber (CA) und die mechano-chemische Ablation.

Dieser Artikel gibt einen Überblick über die aktuell vorliegenden Daten zur Wirksamkeit und Sicherheit von NTNT-Methoden.

Gemäß der Literatur besitzen NTNT-Methoden eine hohe Wirksamkeit, vergleichbar mit EVTA-Techniken, und weisen eine akzeptable Zunahme der Risiken auf. Es sind jedoch weitere Studien mit Langzeitergebnissen, auch im Hinblick auf Sicherheitsaspekte, notwendig.

Key words

non-thermal non-tumescent techniques - cyanoacrylate adhesive closure - mechanochemical ablation

Schlüsselwörter

nichtthermische Techniken ohne Tumeszenz - Cyanacrylat-Verklebung - mechano-chemische Ablation


Publication History

Article published online:
08 July 2020

© Georg Thieme Verlag KG
Stuttgart · New York

 

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