The Clinical and Histological Effects of Ethanolamine in Varicose Veins

Objective: To study the histological changes in varicosities after injection of 5% ethanolamine. Design: A prospective study in nine groups of six patients awaiting bilateral varicose vein surgery. Patients: Each patient had a below-knee incompetent perforating vein injected with either 0.5, 1.0 or 2.0 ml 5% ethanolamine. The contralateral varicosity received a similar volume of normal saline. Intervention: The patients wore elasticated stockings until admitted for operation at 2, 4 or 8 weeks after the injections. The injected varicosity was then dissected out. Main outcome measures: Each vein was reported on by a histologist who did not know which had received ethanolamine or saline. The histologist graded each vein according to the severity of change from 0 (no effect) to 5 (total obliteration of vein). Results: Ethanolamine at 0.5, 1.0 and 2.0 ml caused extensive histological damage to the varicosity. After 8 weeks most varicosities had been destroyed. Conclusion: Ethanolamine, unlike sodium tetradecyl sulphate, causes complete destruction of a varicosity. A dose of 0.5 ml is just as effective as 2.0 ml.