Sclerotherapy: a study comparing polidocanol in foam and liquid form

2010 ◽  
Vol 25 (1) ◽  
pp. 44-49 ◽  
Author(s):  
H Uncu
Keyword(s):  
Side Effects ◽  
Varicose Veins ◽  
Statistical Significance ◽  
Complete Disappearance ◽  
Women Patients ◽  
Foam Sclerotherapy ◽  
Liquid Form ◽  
Sclerosing Agents ◽  
Sclerosing Solutions ◽  
Significant Difference

Objectives Compression sclerotherapy has been satisfactorily used for half a century for the treatment of varicose veins of the lower extremities. The effect of sclerosing solutions is that of making endofibrosis and vascular damage via producing endothelial injury. Different sclerosing agents were used by applying many different sclerotherapy methods. In recent years, sclerosing foam has been introduced in sclerotherapy with the goal of increasing the efficacy in the treatment of varicose veins. It is still uncertain whether foam or liquid form is superior. The aim of this study is to determine the efficacy and safety of the sclerosant polidocanol – which is a well-known detergent-type sclerosing agent – in foam form compared with liquid form. Methods A total of 100 women patients with telengiectases and small varicose veins of less than 4 mm were included in this study. The patients were divided into two groups according to presenting dates. Fifty patients who presented first were classified as the first group. They were treated with Tessari's foam sclerotherapy method. The second fifty patients who presented later were placed in the second group. They were treated with the liquid form of polidocanol. Extremity veins that did not have insufficiency at the saphenofemoral junction were divided into three groups as <1 mm, 1–2 mm and >2 but <4 mm, and the veins were treated with 0.25%, 0.5% or 1% of polidocanol, respectively. Clinical improvement, patients' complaints and side-effects were determined after treatment. Results Complete disappearance was determined in 84% of patients in the foam form group and in 72% in the liquid form group. Although polidocanol in foam form's success rate was higher than the liquid form of polidocanol to clear the vessels, this result did not reach statistical significance ( P = 0.148). There was no significant difference also in the side effects between each group. Conclusion Compression sclerotherapy is an effective and useful method for treating small varicose veins and telengiectases. Both polidocanol foam and polidocanol liquid forms are effective and safe sclerosing agents. The rates of side-effects were similar for both sclerotherapy methods. Although efficacy to clear the small varicose veins and telengiectases with foam polidocanol seems to be more successful than with liquid polidocanol, it is early to declare the superiority of the foam sclerotherapy method.

Risk of venous thromboembolism following surgical treatment of superficial venous incompetence

VASA ◽  
2017 ◽  
Vol 46 (6) ◽  
pp. 484-489 ◽  
Author(s):  
Tom Barker ◽  
Felicity Evison ◽  
Ruth Benson ◽  
Alok Tiwari
Keyword(s):  
Venous Thromboembolism ◽  
Varicose Vein ◽  
Lower Incidence ◽  
Varicose Veins ◽  
Secondary Data ◽  
Foam Sclerotherapy ◽  
Increased Risk ◽  
Significant Difference ◽  
Chi Squared ◽  
One Year

Abstract. Background: The invasive management of varicose veins has a known risk of post-operative deep venous thrombosis and subsequent pulmonary embolism. The aim of this study was to evaluate absolute and relative risk of venous thromboembolism (VTE) following commonly used varicose vein procedures. Patients and methods: A retrospective analysis of secondary data using Hospital Episode Statistics database was performed for all varicose vein procedures performed between 2003 and 2013 and all readmissions for VTE in the same patients within 30 days, 90 days, and one year. Comparison of the incidence of VTEs between procedures was performed using a Pearson’s Chi-squared test. Results: In total, 261,169 varicose vein procedures were performed during the period studied. There were 686 VTEs recorded at 30 days (0.26 % incidence), 884 at 90 days (0.34 % incidence), and 1,246 at one year (0.48 % incidence). The VTE incidence for different procedures was between 0.15–0.35 % at 30 days, 0.26–0.50 % at 90 days, and 0.46–0.58 % at one year. At 30 days there was a significantly lower incidence of VTEs for foam sclerotherapy compared to other procedures (p = 0.01). There was no difference in VTE incidence between procedures at 90 days (p = 0.13) or one year (p = 0.16). Conclusions: Patients undergoing varicose vein procedures have a small but appreciable increased risk of VTE compared to the general population, with the effect persisting at one year. Foam sclerotherapy had a lower incidence of VTE compared to other procedures at 30 days, but this effect did not persist at 90 days or at one year. There was no other significant difference in the incidence of VTE between open, endovenous, and foam sclerotherapy treatments.

Can foam sclerotherapy be used to safely treat bilateral varicose veins?

2011 ◽  
Vol 27 (1) ◽  
pp. 19-24 ◽  
Author(s):  
R H Bhogal ◽  
C E Moffat ◽  
P Coney ◽  
I K Nyamekye
Keyword(s):  
Varicose Veins ◽  
Visual Disturbance ◽  
Complication Rates ◽  
Treatment Episode ◽  
Ultrasound Guided ◽  
Foam Sclerotherapy ◽  
Systemic Complications ◽  
Complete Occlusion ◽  
Vein Occlusion ◽  
Significant Difference

Objective We assessed the use of ultrasound guided foam sclerotherapy (UGFS) to treat bilateral varicose veins either as synchronous or interval procedures. We specifically assessed total foam volume usage and its influence on early outcome and complications. Methods We reviewed our prospectively compiled computerised database of patients with bilateral varicose veins who have undergone UGFS. Duplex findings, foam volumes used and clinical outcome were assessed. Results One hundred and twelve patients had undergone UGFS for bilateral varicose veins. Sixty-one had bilateral UGFS (122 legs) and 51 had interval UGFS (102 legs). Seventy-eight percent bilateral and 60% interval procedures were for single trunk disease. Median foam volumes per treatment episode were: 17.5 mls bilateral, and 10 mls interval FS. At two weeks 81% of legs had complete occlusion after bilateral UGFS compared to 70% after interval UGFS. One patient in the bilateral UGFS developed transient visual disturbance. There was no systemic complications in the interval UGFS. Conclusions Bilateral foam sclerotherapy treatment did not adversly affect vein occlusion rates and there was no significant difference in complication rates between the two groups. Bilateral UGFS can be safely performed in selected patient presenting with bilateral varicose veins.

Endovascular reflux-elimination of perforating veins by RFITT and foam sclerotherapy

Phlebologie ◽  
2015 ◽  
Vol 44 (01) ◽  
pp. 13-17
Author(s):  
J. Duben ◽  
J. Gatek ◽  
T. Saha ◽  
G. Hnatkova ◽  
L. Hnatek
Keyword(s):  
Varicose Veins ◽  
Control Group ◽  
Foam Sclerotherapy ◽  
Perforating Veins ◽  
Significant Difference ◽  
Power Setting ◽  
Group 3 ◽  
Group 2 ◽  
One Year ◽  
Group 1

SummaryIntroduction: During the last years, many endovascular techniques have been developed in order to eliminate not only the reflux in stem veins but in perforating veins and their tributaries, too.Aim: The aim of this study was to use endo -vascular RFITT and the foam sclerotherapy for the occlusion of perforating veins as the prime source of reflux and their tributaries.Material and Methods: The Celon method was used for the thermal treatment. Polydocalon with the concentration 1% and 2% with DSS technique was used for the foam sclerotherapy. The RFITT was accomplished in 127 perforating veins in total. This group was divided into three subgroups. The first one consists of patients where only RFITT was carried out (n= 41), in the second, there were patients with RFITT realized with sclerotherapy during one session (n= 48), in the third, RFITT was completed with sclerotherapy in one month after the RFITT intervention (n= 38). The control group included perforating veins treated only with sclerotherapy (n= 81). The power setting 6W was used on the generator during the RFITT with CelonProSurge micro and 18W for usage of Celon ProCurve probe.Results: The effectiveness of the procedure in the group 1 was 8.8%, in the group two 93.7%, in the group three 92.1% and in the control group 76.5% in one year follow up. There was no significant difference between the effectiveness in groups 1, 2 and 3. The marginal difference was among all three groups with RFITT and the control group. Significant differences were in the parameter of the extinction of visible varicose veins with the reflux from perforators. The extinction was faster in group 3 than in group 2 and in the control group and the slowest was in group 1. The significant difference was observed between groups 2 and 3 compared with group 1 and the margin difference was between groups 2 and 3 compared with the control group. No significant difference was observed between groups 1 and the control group.Conclusions: All procedures are effective. The most important is the combination of RFITT and the sclerotherapy one month after thermal intervention. This is associated with a low risk of recanalization and the fastest extinction of visible varicose veins.

A comparative study between the dispersible Ferric pyrophosphate particles and Ferrous sulfate in treatment of pediatric patients with iron deficiency anemia

2021 ◽  
Author(s):  
Fady M. El-Gendy ◽  
Ayat A El- Gendy ◽  
Mahmoud A. El-Hawy
Keyword(s):  
Side Effects ◽  
Iron Deficiency ◽  
Iron Deficiency Anemia ◽  
Ferrous Sulfate ◽  
Complete Blood Count ◽  
Deficiency Anemia ◽  
P Value ◽  
Liquid Form ◽  
Ferric Pyrophosphate ◽  
Significant Difference

Background: Iron deficiency anemia (IDA) is the most common type of anemia related to malnutrition worldwide. It represents a major problem in developing countries, especially in Egypt. Ferric pyrophosphate (FPP) is a water-insoluble iron compound often used to fortify infant cereals and chocolate drink powders. It causes no adverse color and flavor changes to food vehicles. This study was done to compare the efficacy of FPP (micro dispersed iron) and ferrous sulfate (FS) in treating childhood IDA. Materials and Methods: This prospective cohort study was conducted on 58 anemic children visiting the outpatient clinic, pediatric department of Menoufia University hospitals from March 2017 to June 2019. The inclusion criteria of the involved children were age 2 - 12 years and the diagnosis of IDA. Patients with other types of anemia were excluded from the study. Verbal permission was obtained from the parents of the children according to the ethical committee of Menoufia University. Patients were randomly divided into 2 groups. Group1 included 29 children who were treated with FPP and group2 included 29 children who were treated with oral traditional iron in the form of FS. Complete blood count and iron profile were recorded before and after 8 weeks of treatment. Results: The results showed no statistically significant difference between the FPP group and the FS group regarding clinical examinations (P-value > 0.05). There was no significant difference regarding hemoglobin, serum iron, and serum ferritin between the FPP and the FS groups after treatment (P-value> 0.05). However, side effects were significantly higher in the FS group (P-value > 0.001). Conclusion: Micro dispersed iron could be used as an alternative therapy for children with IDA who refuse oral iron therapy in a liquid form with more tolerability and fewer side effects.

Adverse neurological events after sodium tetradecyl sulfate foam sclerotherapy – A prospective, observational study of 8056 treatments

2021 ◽  
pp. 026835552110514
Author(s):  
Huw OB Davies ◽  
Mike Watkins ◽  
Richard Oliver ◽  
Sarah Berhane ◽  
Andrew W Bradbury
Keyword(s):  
Logistic Regression ◽  
Adverse Events ◽  
Varicose Veins ◽  
Past History ◽  
Statistical Significance ◽  
Adjunctive Treatment ◽  
Sodium Tetradecyl Sulfate ◽  
Foam Sclerotherapy ◽  
Serious Adverse Events ◽  
Foam Volume

Background Ultrasound guided foam sclerotherapy (UGFS) is a flexible and highly utilised tool in the treatment of varicose veins (VVs), both as a primary treatment and as an adjunct to other treatments. Concern remains regarding the risk of neurological adverse events (AEs) such as migraine, visual disturbance and serious adverse events (SAEs) such as cerebrovascular accident that have been reported after UGFS treatments. Aim To determine the incidence of neurological AEs and SAEs after UGFS. Methods A prospective, multicentre, post-authorisation safety study across Europe (both private and government) was performed between January 2015–2020. Neurological adverse events after UGFS with Fibrovein® (Sodium Tetradecyl Sulfate) 1 and 3% physician generated foam. Results 8056 patients underwent treatment. There were 46 AE (including 5 SAEs), 30 (65%) SAEs were in female patients. Mean age was 55 years with mean body mass index (BMI) of 27. Univariable logistic regression demonstrate that UGFS only treatment (i.e. no adjunctive treatment), liquid-to-gas ratio, gas type and total foam volume (1% sodium tetradecyl sulfate, STS) were significantly associated with the odds of experiencing the outcome. Multivariable logistic regression model exhibits that migraine and total foam volume (1% STS) maintained statistical significance thus associated with the odds of adverse events. Conclusions This study demonstrates that UGFS with Fibrovein is safe with a very low incidence of neurological AEs and SAEs. Past history of migraine, use of physiological gas (O2/CO2) and increasing volumes of 1% foam increase the risk of AEs.

Study on the Effect of Nano Albumin Paclitaxel Combined with Carboplatin in the Treatment of Lung Squamous Cell Carcinoma

2020 ◽  
Vol 20 (12) ◽  
pp. 7439-7443
Author(s):  
Hui Wang ◽  
Shaoyu Mou ◽  
Min Tu
Keyword(s):  
Squamous Cell Carcinoma ◽  
Side Effects ◽  
Cell Carcinoma ◽  
Squamous Cell ◽  
Advanced Nsclc ◽  
Statistical Significance ◽  
Lung Squamous Cell Carcinoma ◽  
Albumin Binding ◽  
Significant Difference ◽  
Carboplatin Auc

This study aims to compare the efficacy and side effects of albumin-binding paclitaxel plus carboplatin (NAB PC) and paclitaxel plus carboplatin (PC) in the first-line treatment of advanced non-small cell lung cancer (NSCLC). A total of 60 patients with advanced NSCLC diagnosed by histopathology or cytology were randomly divided into nab PC group (albumin-binding paclitaxel 130 mg/mL, D1, D; carboplatin AUC = 6, D1) and PC group (paclitaxel 175 mg/mL, D1; carboplatin AUC = 6, D1), one cycle every three weeks. RECIST 1.1 standard was used to evaluate the short-term objective efficacy, and who acute and subacute toxicity classification standard was used to evaluate the toxicity. The total effective rate (RR) and disease control rate (DCR) of NAB PC group were 40.0% and 80.0%, respectively, which were higher than 23.3% and 60.0% of the PC group, respectively. This difference was statistically significant (p < 0.05). In squamous cell carcinoma, the RR of NAB PC group and PC group were 57.1% (8/14) and 23.1% (3/13) respectively, with a statistically significant difference (p < 0.05); in non-squamous cell carcinoma, the RR of the two groups were 25.0% (4/16) and 23.3% (4/17) without statistical significance (p > 0.05). The median progression free survival time of the NAB PC group and PC group was 6.5 and 5.9 months, respectively, with no significant difference (p>0.05). No significant difference arose in the incidence of grade III–IV toxicity between the two groups (p > 0.05). The incidence of neutropenia in the NAB PC group was higher than that in the PC group (p < 0.05). The therapeutic effect of paclitaxel combined with carboplatin in the treatment of advanced NSCLC is better, the effect of paclitaxel combined with carboplatin is better, and the side effects can be tolerated, which is worthy of clinical application. Patients are more satisfied with their care.

Complications and side-effects of foam sclerotherapy

2009 ◽  
Vol 24 (6) ◽  
pp. 270-274 ◽  
Author(s):  
J-J Guex
Keyword(s):  
Informed Consent ◽  
Side Effects ◽  
Current Literature ◽  
Foam Sclerotherapy ◽  
Sclerosing Agents ◽  
Personal Research

Aims To describe and report incidence and frequency of side-effects and complications of sclerotherapy with foamed sclerosing agents. To explain, when possible, their pathophysiology and to indicate possible manoeuvres and techniques to limit them. Methods Review of current literature and personal research. Results Complications of foam sclerotherapy include complications of sclerotherapy in general and specific complications of foamed sclerosing agents. Side-effects related to the sclerosing compounds are also taken into account. Conclusion Complications and side-effects of careful foam sclerotherapy remain uncommon. However, more research is needed to understand them better and to further reduce their incidence. Their description to patients in the course of the informed consent is a prerequisite to any sclerosing treatment.

The Australian Polidocanol (Aethoxysklerol) Study: Results at 1 Year

1994 ◽  
Vol 9 (1) ◽  
pp. 17-20 ◽  
Author(s):  
P. Conrad ◽  
G. M. Malouf ◽  
M. C. Stacey
Keyword(s):  
Side Effects ◽  
Prospective Study ◽  
Hypertonic Saline ◽  
Varicose Veins ◽  
Previous Experience ◽  
Private Practices ◽  
Sclerosing Agents ◽  
Study Results ◽  
Sodium Tetradecyl Sulphate ◽  
Spider Veins

Objective: To evaluate the complications of polidocanol and compare its effectiveness and complications with sodium tetradecyl sulphate (STD) and hypertonic saline. Design: A single-arm prospective study of polidocanol complications and its effectiveness as a sclerosant. This was compared with each investigator's previous experience with other sclerosing agents. Setting: Multiple investigators in both private practices and hospital settings. Patients: Patients had either varicose veins or venule ectasias and/or spider veins (telangiectasia). A total of 8177 limbs were injected by 75 investigators. Interventions: Sclerotherapy was performed with 0.5% or 1% polidocanol for telangiectasias or spider veins, and with 3% polidocanol for varicose veins. The effectiveness of the sclerotherapy and any complications were reported during a 12-month period. Results: There were very few complications reported with polidocanol. There were no reported deaths or anaphylaxis. The investigators with previous experience of other sclerosants considered that the effectiveness of polidocanol was superior to STD (77%) and hypertonic saline (75%). Ninety-one per cent of investigators considered that polidocanol had less frequent complications than STD, and 96% considered that these were less severe. Sixty-nine per cent considered that polidocanol had fewer side-effects than hypertonic saline, and 71% considered that these were less severe. Conclusions: Polidocanol is an effective sclerosant that has few complications.

scholarly journals Comparison of microbubble presence in the right heart during mechanochemical and radiofrequency ablation for varicose veins

2016 ◽  
Vol 32 (6) ◽  
pp. 425-432 ◽  
Author(s):  
KH Moon ◽  
B Dharmarajah ◽  
R Bootun ◽  
CS Lim ◽  
TRA Lane ◽  
...  
Keyword(s):  
Radiofrequency Ablation ◽  
Varicose Veins ◽  
Neurological Complications ◽  
Ultrasound Guided ◽  
Foam Sclerotherapy ◽  
Right Heart ◽  
International Consensus ◽  
Mechanochemical Ablation ◽  
Significant Difference ◽  
The Right

Objective Mechanochemical ablation is a novel technique for ablation of varicose veins utilising a rotating catheter and liquid sclerosant. Mechanochemical ablation and radiofrequency ablation have no reported neurological side-effect but the rotating mechanism of mechanochemical ablation may produce microbubbles. Air emboli have been implicated as a cause of cerebrovascular events during ultrasound-guided foam sclerotherapy and microbubbles in the heart during ultrasound-guided foam sclerotherapy have been demonstrated. This study investigated the presence of microbubbles in the right heart during varicose vein ablation by mechanochemical abaltion and radiofrequency abaltion. Methods Patients undergoing great saphenous vein ablation by mechanochemical abaltion or radiofrequency ablation were recruited. During the ablative procedure, the presence of microbubbles was assessed using transthoracic echocardiogram. Offline blinded image quantification was performed using International Consensus Criteria grading guidelines. Results From 32 recruited patients, 28 data sets were analysed. Eleven underwent mechanochemical abaltion and 17 underwent radiofrequency abaltion. There were no neurological complications. In total, 39% (11/28) of patients had grade 1 or 2 microbubbles detected. Thirty-six percent (4/11) of mechanochemical abaltion patients and 29% (5/17) of radiofrequency ablation patients had microbubbles with no significant difference between the groups ( p=0.8065). Conclusion A comparable prevalence of microbubbles between mechanochemical abaltion and radiofrequency ablation both of which are lower than that previously reported for ultrasound-guided foam sclerotherapy suggests that mechanochemical abaltion may not confer the same risk of neurological events as ultrasound-guided foam sclerotherapy for treatment of varicose veins.

Foam sclerotherapy

Phlebologie ◽  
2008 ◽  
Vol 37 (04) ◽  
pp. 211-220 ◽  
Author(s):  
N. Morrison
Keyword(s):  
Side Effects ◽  
Femoral Vein ◽  
High Concentration ◽  
Intravenous Catheter ◽  
Foam Sclerotherapy ◽  
Indwelling Catheter ◽  
Stable Foam ◽  
Vigorous Agitation ◽  
Sclerosing Agents ◽  
Saphenofemoral Junction

SummaryMethods to improve the efficacy of foam sclerotherapy might include: more vigorous agitation methods to produce more stable foam with smaller bubble size, increasing the volume and/or concentration of the sclerosing agent, use of an intravenous catheter, and leg elevation to evacuate as much blood as possible. Methods to improve the safety of foam sclerotherapy might include: use of an intravenous indwelling catheter; saphenofemoral junction occlusion; low foam volume; use of low silicon syringes; use of non airbased foam; avoidance of high concentration sclerosing agents in patients with duplicated femoral vein segments; leg elevation before or after injection of foam; and maintaining patient immobility after injection.A series of studies and exercises are described which call into question many methods proposed to limit the dispersal of injected foam. The use of non air-based foam may reduce the incidence of side effects.

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