{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,23]],"date-time":"2026-10-23T17:39:06Z","timestamp":1792777146576,"version":"4.5.0"},"reference-count":15,"publisher":"SAGE Publications","license":[{"start":{"date-parts":[[2026,10,21]],"date-time":"2026-10-21T00:00:00Z","timestamp":1792540800000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.sagepub.com\/page\/policies\/text-and-data-mining-license"}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["Phlebology"],"abstract":"<jats:sec>\n                    <jats:title>Objectives<\/jats:title>\n                    <jats:p>Truncal cyanoacrylate closure (CAC) does not treat refluxing tributary varicosities. We describe Side-branch Local Injection of Cyanoacrylate Embolization (SLICE) \u2014 ultrasound-guided injection of the VenaSeal adhesive into refluxing tributaries during truncal CAC \u2014 and assess its technical feasibility and periprocedural safety.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>Single-center retrospective review of 32 consecutive patients (49 limbs, 58 truncal veins) treated by truncal CAC between September 2024 and December 2025; SLICE was performed in 14. The primary endpoint was technical success, defined as the absence of reflux within an injected tributary on the first postoperative duplex study. Secondary endpoints included 3-month durability, truncal occlusion, and adverse events.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      22 refluxing tributaries were injected; all were epifascial, at a median depth of 4.0\u00a0mm (range 1.2\u20139.6). A median of four dispenser trigger pulls was used per site (range 3\u20138); the series was underpowered to relate pull count to diameter (Spearman rho \u22120.16,\n                      <jats:italic toggle=\"yes\">p<\/jats:italic>\n                      = 0.50). Technical success was 21\/22 (95%; 95% confidence interval 77.2\u201399.9) initially and 19\/20 (95%; 75.1\u201399.9) at 3\u00a0months. On 3-month computed tomography (CT), 14 of 17 evaluable injected tributaries were occluded whereas 16 of 17 were free of reflux: anatomical occlusion lagged behind hemodynamic success. Truncal occlusion was preserved (30\/30 at 1\u00a0week; 26\/27 at 3\u00a0months). There was no phlebitis, deep vein thrombosis, pulmonary embolism, or adhesive removal. Hyperpigmentation occurred in 3\/14 patients, all with an injection &lt;2\u00a0mm below the skin; two mild delayed hypersensitivity reactions occurred, both over the truncal rather than an injected site. One patient (7%) required re-intervention.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>SLICE is technically feasible and reproducible within a narrow range of adhesive delivery, with no adhesive-related complication at an injected site in this small series with short follow-up. Prospective comparative evaluation with patient-centered endpoints is required before efficacy can be claimed.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1177\/02683555261499764","type":"journal-article","created":{"date-parts":[[2026,10,21]],"date-time":"2026-10-21T08:13:56Z","timestamp":1792570436000},"update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":0,"title":["Ultrasound-guided cyanoacrylate embolization of refluxing tributaries during truncal cyanoacrylate closure (SLICE): Technique description and a proof-of-concept feasibility study"],"prefix":"10.1177","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-2308-6404","authenticated-orcid":false,"given":"Koki","family":"Ikebata","sequence":"first","affiliation":[{"name":"Ashikaga Red Cross Hospital"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Takashi","family":"Hashimoto","sequence":"additional","affiliation":[{"name":"Ashikaga Red Cross Hospital"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hiroaki","family":"Kaneyama","sequence":"additional","affiliation":[{"name":"Ashikaga Red Cross Hospital"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kiyoshi","family":"Koizumi","sequence":"additional","affiliation":[{"name":"Ashikaga Red Cross Hospital"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hideyuki","family":"Shimizu","sequence":"additional","affiliation":[{"name":"Keio University Hospital"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"179","published-online":{"date-parts":[[2026,10,21]]},"reference":[{"key":"e_1_3_8_2_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.jvsv.2012.09.010"},{"key":"e_1_3_8_3_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.jvs.2014.11.071"},{"key":"e_1_3_8_4_2","doi-asserted-by":"publisher","DOI":"10.1177\/0268355518801641"},{"key":"e_1_3_8_5_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.ejvs.2020.05.028"},{"key":"e_1_3_8_6_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.jvsv.2023.08.011"},{"key":"e_1_3_8_7_2","doi-asserted-by":"publisher","DOI":"10.1177\/0268355517733339"},{"key":"e_1_3_8_8_2","doi-asserted-by":"publisher","DOI":"10.1177\/0268355514529696"},{"key":"e_1_3_8_9_2","doi-asserted-by":"publisher","DOI":"10.1177\/0268355519878618"},{"key":"e_1_3_8_10_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.jvsv.2020.01.009"},{"key":"e_1_3_8_11_2","doi-asserted-by":"publisher","DOI":"10.1177\/0268355520901662"},{"key":"e_1_3_8_12_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.jvsv.2020.12.074"},{"key":"e_1_3_8_13_2","doi-asserted-by":"publisher","DOI":"10.7134\/phlebol.20-20"},{"key":"e_1_3_8_14_2","doi-asserted-by":"publisher","DOI":"10.1177\/0268355519826008"},{"key":"e_1_3_8_15_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.jvsv.2023.03.018"},{"key":"e_1_3_8_16_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.jvsv.2026.102462"}],"container-title":["Phlebology: The Journal of Venous Disease"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/journals.sagepub.com\/doi\/pdf\/10.1177\/02683555261499764","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/journals.sagepub.com\/doi\/full-xml\/10.1177\/02683555261499764","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/journals.sagepub.com\/doi\/pdf\/10.1177\/02683555261499764","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,10,23]],"date-time":"2026-10-23T16:56:56Z","timestamp":1792774616000},"score":1,"resource":{"primary":{"URL":"https:\/\/journals.sagepub.com\/doi\/10.1177\/02683555261499764"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,10,21]]},"references-count":15,"alternative-id":["10.1177\/02683555261499764"],"URL":"https:\/\/doi.org\/10.1177\/02683555261499764","relation":{},"ISSN":["0268-3555","1758-1125"],"issn-type":[{"value":"0268-3555","type":"print"},{"value":"1758-1125","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,10,21]]},"article-number":"02683555261499764"}}