An investigation on the influence of glycerin on sclerosant foam stability

2011 ◽  
Vol 26 (6) ◽  
pp. 232-234 ◽  
Author(s):  
J D Peterson ◽  
M P Goldman
Keyword(s):  
Half Life ◽  
Foam Stability ◽  
Varicose Veins ◽  
Injection Technique ◽  
Foam Sclerotherapy ◽  
System Technique ◽  
Negative Effect ◽  
Sodium Tetradecyl Sulphate ◽  
Time Required ◽  
Disposable Plastic

Background Foam sclerotherapy is an increasingly popular modality in the treatment of varicose veins. Foam stability varies according to foam composition, volume and injection technique. Materials and methods A disposable plastic connector was used to create foam from 0.50% sodium tetradecyl sulphate (STS) mixed with varying volumes of glycerin. As a measure of foam stability, the half liquid time was defined as the time required for half of the original volume of sclerosing solution to settle. Three recordings were determined for each of the three mixtures of sclerosant foam. Results The time for sclerosing solution to settle to half of its initial volume was found to be 89 seconds for 0.50% STS alone, 117.7 seconds with the addition of 0.1 mL of 72% glycerin, and 114.7 seconds with the addition of 0.2 mL of 72% glycerin. Conclusion The small volumes of glycerin added to STS prolonged the half liquid time of STS foam up to 35%. As glycerin alone is unable to be foamed with the double-syringe system technique there may be a point at which further addition of glycerin has a negative effect on the half-life of foam.

scholarly journals Exacerbation of alopecia areata: A possible complication of sodium tetradecyl sulphate foam sclerotherapy treatment for varicose veins

2017 ◽  
Vol 5 ◽  
pp. 2050313X1771264 ◽  
Author(s):  
Mark S Whiteley ◽  
Victoria C Smith
Keyword(s):  
Alopecia Areata ◽  
Varicose Veins ◽  
Clinical Score ◽  
Severe Exacerbation ◽  
Hormonal Changes ◽  
Foam Sclerotherapy ◽  
Endovenous Laser Ablation ◽  
Pelvic Vein ◽  
History Of ◽  
Sodium Tetradecyl Sulphate

A 40-year-old woman with a history of alopecia areata related to stress or hormonal changes was treated for bilateral primary symptomatic varicose veins (CEAP clinical score C2S) of pelvic origin, using a staged procedure. Her first procedure entailed pelvic vein embolisation of three pelvic veins using 14 coils and including foam sclerotherapy of the tributaries, using 3% sodium tetradecyl sulphate. Following this procedure, she had an exacerbation of alopecia areata with some moderate shedding of hair. Subsequently, she underwent endovenous laser ablation under local anaesthetic without incident. Seven months after the pelvic vein embolisation, she underwent foam sclerotherapy of leg and labial varicose veins using sodium tetradecyl sulphate. Two days following this procedure, she had a severe exacerbation of alopecia areata with gross shedding of hair. These two episodes of exacerbation of alopecia areata appear to be associated with sodium tetradecyl sulphate foam sclerotherapy of veins.

An Optical Method for Immediate Evaluation of Microfoam Stability in Foam Sclerotherapy

2021 ◽  
Vol 34 (3) ◽  
pp. 128-134
Author(s):  
Taoping Bai ◽  
Wentao Jiang ◽  
Lin Liang ◽  
Yalan Li ◽  
Yubo Fan
Keyword(s):  
Half Life ◽  
Optical Method ◽  
Clinical Performance ◽  
Foam Stability ◽  
Life Time ◽  
Optical Methods ◽  
Foam Sclerotherapy ◽  
Drainage Rate ◽  
Short Period ◽  
The Stability

<b><i>Objectives:</i></b> The objective of our study was to develop an optical method that instantly evaluates the stability of sclerosing foam, which would enable early predictions of the clinical performance of the foam and reduce the occurrence of clinical side effects. <b><i>Methods:</i></b> Based on the principle of light scattering, we developed a method to optically test foam stability and verified it experimentally using sodium morrhuate (2 mL; 0.05 g/mL) and carbon dioxide. A self-made foam preparation instrument was used to achieve a preparation speed of 275 mm/s. The liquid-gas ratios were considered as 1:3, 1:4, and 1:5. Curves of illuminance with respect to the drainage rate and decay time were obtained. By fitting the curve, the relationship between foam half-life time (FHT) and foam decay was obtained. Thus, foam stability was evaluated using the initial illuminance value; the foam transfer time was approximately 3 s. <b><i>Results:</i></b> The experimental FHT varies between 205 and 232 s. Illuminance is exponentially related to drainage rate and linearly related with time. FHT can be expressed by the initial illuminance and illuminance curve fitting coefficients. The half-life of the foam decreases as the initial illuminance value increases, for the same sclerosing drug. The suitability of foam stability is determined by the position of the initial value in the chart. <b><i>Conclusion:</i></b> Optical methods are feasible for evaluating foam stability over a short period of time. Clinically predicting the stability of freshly prepared foam can reduce number of incidences of further complications. This will promote the development of foam sclerotherapy and provide a basic understanding of the internal mechanical properties of foam.

Results from RCTs in Sclerotherapy: European Guidelines for Sclerotherapy in Chronic Venous Disorders*

2014 ◽  
Vol 29 (1_suppl) ◽  
pp. 39-44 ◽  
Author(s):  
F Pannier ◽  
E Rabe ◽  
Keyword(s):  
Intravenous Injection ◽  
Varicose Veins ◽  
German Society ◽  
Evidence Based ◽  
Venous Malformations ◽  
Foam Sclerotherapy ◽  
European Guidelines ◽  
Chemical Ablation ◽  
Sodium Tetradecyl Sulphate ◽  
Venous Disorders

Aim Sclerotherapy is the targeted chemical ablation of varicose veins by intravenous injection of a liquid or foamed sclerosing drug. The treated veins may be intradermal, subcutaneous, and/or transfascial as well as superficial and deep in venous malformations. The aim of this guideline is to give evidence-based recommendations for liquid and foam sclerotherapy. Methods This guideline was drafted on behalf of 23 European Phlebological Societies during a Guideline Conference on 7th–10th May 2012 in Mainz. The conference was organized by the German Society of Phlebology. Results This guideline focuses on the two sclerosing drugs which are licensed in the majority of the European countries, Polidocanol (POL) and Sodium tetradecyl sulphate (STS). Other sclerosants are not discussed in detail. In this paper the results from recent RCTs in sclerotherapy are reviewed.

An investigation of side-effects and efficacy of foam-based sclerotherapy with carbon dioxide or room air in the treatment of reticular leg veins: a pilot study

2011 ◽  
Vol 27 (2) ◽  
pp. 73-76 ◽  
Author(s):  
J D Peterson ◽  
M P Goldman
Keyword(s):  
Carbon Dioxide ◽  
Pilot Study ◽  
Side Effects ◽  
Half Life ◽  
P Value ◽  
Foam Sclerotherapy ◽  
Sodium Tetradecyl Sulphate ◽  
Foam Concentration ◽  
Local Side

Objectives In sclerotherapy, carbon dioxide (CO2) or room air can be employed by phlebologists for foam creation. We compared room air (RA) and carbon dioxide in treating reticular leg veins with foam sclerotherapy. Methods Twenty patients were randomly treated with RA- or CO2-created sodium tetradecyl sulphate (STS) foam. Concentration and volume of STS, side-effects and efficacy were determined. Results There was no difference in the efficacy, local side-effects or distant side-effects between RA and CO2 foam in the treatment of reticular leg veins. The total volume of foam sclerosant required for treatment was greater with CO2 compared with RA ( P value = 0.01). Conclusion No differences were found in efficacy or side-effects between RA- and CO2-foam sclerotherapy for reticular leg veins. CO2 foam's shorter half-life was hypothesized to be responsible for larger total volumes of CO2 foam sclerosant.

Indications, contraindications and performance: European Guidelines for Sclerotherapy in Chronic Venous Disorders

2014 ◽  
Vol 29 (1_suppl) ◽  
pp. 26-33 ◽  
Author(s):  
E Rabe ◽  
F Pannier ◽  
Keyword(s):  
Varicose Veins ◽  
German Society ◽  
Evidence Based ◽  
Venous Malformations ◽  
Foam Sclerotherapy ◽  
European Guidelines ◽  
Chemical Ablation ◽  
Sodium Tetradecyl Sulphate ◽  
And Performance ◽  
Venous Disorders

Aim Sclerotherapy is the targeted chemical ablation of varicose veins by intravenous injection of a liquid or foamed sclerosing drug. The treated veins may be intradermal, subcutaneous, and/or transfascial as well as superficial and deep in venous malformations. The aim of this guideline is to give evidence-based recommendations for liquid and foam sclerotherapy. Methods This guideline was drafted on behalf of 23 European Phlebological Societies during a Guideline Conference on 7th – 10th May 2012 in Mainz. The conference was organized by the German Society of Phlebology. Results This guideline focuses on the two sclerosing drugs which are licensed in the majority of the European countries, Polidocanol (POL) and Sodium tetradecyl sulphate (STS). Other sclerosants are not discussed in detail. In this paper the recommendations concerning indications, contraindications, concentrations, volumes and technique of liquid and foam sclerotherapy of varicose veins and venous malformations are reviewed.

scholarly journals Efficacy and safety of ultrasound guided foam sclerotherapy with sodium tetradecyl sulphate for residual and minor varicosities

2017 ◽  
Vol 4 (2) ◽  
pp. 751
Author(s):  
Madhu B. S. ◽  
Shashi Kumar H. B. ◽  
Naveen Kumar Reddy M. ◽  
Sangeetha Kalabhairav ◽  
Abilash Reddy V.
Keyword(s):  
Varicose Veins ◽  
Single Session ◽  
Ultrasound Guided ◽  
Foam Sclerotherapy ◽  
Medical College ◽  
Vein Thrombosis ◽  
Post Surgery ◽  
Sodium Tetradecyl Sulphate ◽  
Deep Vein ◽  
Symptoms And Signs

Background: Ultrasound-guided foam sclerotherapy (UGFS) is becoming an accepted standard of treatment varicose veins. It is a relatively safe, effective inexpensive method in limited, small varicose veins.This study aims to assess the safety and efficacy of UGFS using sodium tetradecyl sulphate (setrol) in patients presenting with minor varicosities and residual varicosities of lower limb.Methods: 78 patients with minor varicosities or residual varicosities post-surgery who presented between January2015 and June2016 at KR hospital attached to Mysore Medical College and Research Institute, Mysuru, underwent ultrasound-guided foam sclerotherapy with 0.5ml (at a single session) setrol prepared as a foam by Tessari technique. The efficacy criterion was the disappearance of the varicosities and improvement in symptoms and signs: 1 week, and 1, 3, 6 and 12 months after the treatment. Complications of sclerotherapy were reported during follow-up.Results: Decrease or withdrawal of complaints was reported in 96% of cases (74 patients). Disappearance or decrease of varicose veins was observed in all patients (100%). Phlebitis and pigmentation as a complication was noted in 5 (7%) and 9 (11.5%) cases respectively. Major complications, such as deep vein thrombosis, pulmonary embolism, dyspnoea, anaphylaxis, or neurological abnormalities, were not reported.Conclusions: Ultrasound-guided foam sclerotherapy for minor varicosities and residual varicosities with sodium tetra decyl sulphate is a safe and satisfactory method of treatment of minor and residual varicosities.

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.

Histological changes following foam sclerotherapy (FS) with sodium tetradecyl sulphate (STD)

2009 ◽  
Vol 96 (S1) ◽  
pp. 14-15 ◽  
Author(s):  
A. Ikponmwosa ◽  
C. Abbott ◽  
S. Homer-Vanniasinkam ◽  
M. J. Gough
Keyword(s):  
Foam Sclerotherapy ◽  
Histological Changes ◽  
Sodium Tetradecyl Sulphate

Detection of residual varicose veins with near infrared light in the early period after varicose surgery and near infrared light assisted sclerotherapy

Vascular ◽  
2021 ◽  
pp. 170853812110514
Author(s):  
Nail Kahraman ◽  
Gündüz Yümün ◽  
Deniz Demir ◽  
Kadir K Özsin ◽  
Sadık A Sünbül ◽  
...  
Keyword(s):  
Minimally Invasive ◽  
Saphenous Vein ◽  
Venous Insufficiency ◽  
Near Infrared ◽  
Varicose Veins ◽  
Infrared Light ◽  
Foam Sclerotherapy ◽  
Near Infrared Light ◽  
Nir Light ◽  
Male Patients

Objectives Varicose veins that cannot be seen with the naked eye can be easily detected with Near Infrared (NIR) light. With a minimally invasive procedure performed with NIR light guided, the need for reoperation is reduced, while optimal treatment of venous insufficiency and symptoms is provided. In this study, the detection of residual varicose veins after varicose vein surgery using NIR light and the results of treatment of sclerotherapy were investigated. Methods In this retrospective study, treatment and clinical outcomes of patients’ who underwent NIR light-guided foam sclerotherapy for Clinical-Etiology-Anatomy-Pathophysiology (CEAP) (C1, C2) stage residual varicose veins after surgical varicose treatment between 2014 and 2017 were examined. Data of patients who underwent foam sclerotherapy with NIR light were collected and analyzed. Results A total of 151 patients and 171 lower extremity varicose veins were treated with surgery. 55 (35.7%) of the patients were male, and 96 (62.3%) were female. Their age ranges from 20 to 64, with an average age of 45.38. 4 (2.6%) of the patients had phlebectomy. 137 of patients (90.7%) had ligation of perforated veins, phlebectomy, and great saphenous vein (GSV) stripping, 10 of patients (6.6%) had GSV stripping, perforating vein ligation, phlebectomy, and small saphenous vein (SSV) surgery. No residual leakage was observed in the controls of GSV, SSV, and perforating veins by duplex ultrasonography (DUS). In the first month after varicose surgery, an average of 1.64 ± 1.05 sessions of sclerotherapy was applied to patients with CEAP C1, C2 stage residual varicose veins. 70 patients had one session of sclerotherapy, 37 patients had two sessions of sclerotherapy, 20 patients had three sessions of sclerotherapy, and 11 patients had four sessions of sclerotherapy administrated. The need for complementary therapy was required for all female patients; 13 of the male patients did not require complementary sclerotherapy. While single-session sclerotherapy was applied to most male patients (32 (58.18%), 10 (18.18%) patients received two sclerotherapy sessions. After completing sclerotherapy, 7 (4.63%) patients had superficial venous thrombosis, and 13 (8.60%) patients had hyperpigmentation. Conclusion Surgical treatment is a safe and effective technique in venous insufficiency. Nevertheless, residual varicose veins may remain, and these can be detected noninvasively with NIR light. Foam sclerotherapy with NIR light is a minimally invasive and safe treatment method for small residual varicose veins after the operation. We think that sclerotherapy with NIR light as a complementary treatment is a practical, reliable, and demanding treatment for clinical improvement, especially in female patients.

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