Foam sclerotherapy for lower-limb varicose veins: impact on saphenous vein diameter

Oliveira, Rodrigo Gomes de; Filho, Domingos de Morais; Engelhorn, Carlos Alberto; Kessler, Iruena Moraes; Neto, Felipe Coelho

doi:10.1590/0100-3984.2017.0184

Cited by 6 publications

(10 citation statements)

References 15 publications

(19 reference statements)

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“…The production method and formulation of PEM are rather different compared to PCFs. Most PCFs that are made using polidocanol surfactant use volumetric concentrations of 0.5–3% and room air at a 1:4 liquid to gas ratio (Carugo et al, 2016; de Oliveira, de Morais‐Filho, Engelhorn, Kessler, & Neto, 2018; Rabe & Pannier, 2010; Yiannakopoulou, 2016) to create the desired foam, while PEM uses a 1% polidocanol solution (Carugo et al, 2015) at a 1:7 liquid to gas ratio to improve foam stability. Where PCFs benefit from stability of room air due to the low solubility of nitrogen, Varithena® produces PEM using a low nitrogen (<0.8%) gas combination of 35% CO 2 and 65% O 2 (Carugo et al, 2015; Star et al, 2018) in order to negate the issues of injection of nitrogen into the blood stream (Ceulen, Sommer, & Vernooy, 2008; Forlee, Grouden, Moore, & Shanik, 2006).…”

Section: Foam Sclerotherapymentioning

confidence: 99%

“…The most common surfactants used in foam sclerotherapy (Figure 7) are STS and polidocanol (POL) (Cameron et al, 2013; de Oliveira et al, 2018; Rabe & Pannier, 2010), although other sclerosants used previously include glycerin, hypertonic saline and sodium morrhuate (Yiannakopoulou, 2016). Currently only STS, POL and sodium morrhuate are cleared by the FDA (Gibson & Gunderson, 2018).…”

Section: Foam Sclerotherapymentioning

confidence: 99%

“…Whether valves regenerate following this treatment, at present remains unclear and no studies to date address this question. Furthermore, venous reflux is eliminated (de Oliveira et al, 2018). There is a gap in the literature on the extent of sclerosant diffusion into the vessel wall, and the fate of the treated vessel.…”

Section: Foam Sclerotherapymentioning

confidence: 99%

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Foam‐in‐vein: A review of rheological properties and characterization methods for optimization of sclerosing foams

et al. 2020

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Varicose veins are chronic venous defects that affect >20% of the population in developed countries. Among potential treatments, sclerotherapy is one of the most commonly used. It involves endovenous injection of a surfactant solution (or foam) in varicose veins, inducing damage to the endothelial layer and subsequent vessel sclerosis. Treatments have proven to be effective in the short-term, however recurrence is reported at rates of up to 64% 5-year post-treatment. Thus, once diagnosed with varicosities there is a high probability of a permanently reduced quality of life. Recently, foam sclerotherapy has become increasingly popular over its liquid counterpart, since foams can treat larger and longer varicosities more effectively, they can be imaged using ultrasound, and require lower amounts of sclerosing agent. In order to minimize recurrence rates however, an investigation of current treatment methods should lead to more effective and long-lasting effects. The literature is populated with studies aimed at characterizing the fundamental physics of aqueous foams; nevertheless, there is a significant need for appropriate product development platforms. Despite successfully capturing the microstructural evolution of aqueous foams, the complexity of current models renders them inadequate for pharmaceutical development. This review article will focus on the physics of foams and the attempts at optimizing them for sclerotherapy. This takes the form of a discussion of the most recent numerical and experimental models, as well as an overview of clinically relevant parameters. This holistic approach could contribute to better foam characterization methods that patients may eventually derive long term benefit from.

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Section: Foam Sclerotherapymentioning

confidence: 99%

Section: Foam Sclerotherapymentioning

confidence: 99%

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Foam‐in‐vein: A review of rheological properties and characterization methods for optimization of sclerosing foams

et al. 2020

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“…[ 9 ] Oliveira et al show that foam sclerotherapy reduces the use of anesthesia and shortens the time of hospitalization and bed rest after treatment. [ 10 ]…”

Section: Introductionmentioning

confidence: 99%

Efficacy and safety of polidocanol in the treatment of varicose veins of lower extremities

Huang

et al. 2021

Medicine

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Background: The varicose veins of the lower extremities showed earthworm-like dilatation and venous protrusion of the lower extremities. Polidocanol foam sclerotherapy, as a minimally invasive treatment with rapid recovery, less trauma and not easy to relapse, has achieved good results in clinical, but it is lack of evidence-based medicine. The purpose of this study is to evaluate the efficacy and safety of polidocanol in the treatment of varicose veins of the lower extremities by meta-analysis. Method: Chinese National Knowledge Infrastructure, Wanfang Database, Chinese Scientifific Journals Database, China Biology Medicine disc, PubMed, EMBASE database, Web of Science, and Cochrane Library will be used as search sources to conduct for randomized controlled trials of polidocanol in the treatment of varicose veins of lower extremities. The search time is set from the establishment of the database in December 2020 in this study. Two researchers independently extract, delete files, extract data and evaluate the quality. Revman software version 5.3 will be used for statistical analysis of data. Result: In this study, the efficacy and safety of polidocanol in the treatment of varicose veins of the lower extremities will be evaluated in terms of total effective rate, incidence of complications and recurrence rate. Conclusion: This study will provide reliable evidence-based evidence for the clinical application of polidocanol in the treatment of varicose veins of lower extremities. Ethics and dissemination: Private information from individuals will not be published. This systematic review also does not involve endangering participant rights. Ethical approval will not be required. The results may be published in a peer-reviewed journal or disseminated at relevant conferences. OSF Registration number: DOI 10.17605/OSF.IO/AUR4X.

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“…During such surgeries, after RFA along with necessary perforator ligation and phlebectomy, if there are significant residual veins then adjunct sclerotherapy is an additional modality that helps to reduce residual varicosities [6, 7]. Foam sclerotherapy has reduced anesthetic use, hospital admission and duration of post treatment bed rest [8]. Concomitant use of foam sclerotherapy and Endovenous Laser ablation (EVLA) have reduced reoperation rates and increased early quality of life [9].…”

Section: Introductionmentioning

confidence: 99%

Short Term Outcome of Adjunct Foam Sclerotherapy for Varicose Veins in Patients Subjected to RFA at Dhulikhel Hospital, Nepal

Karmacharya

Shrestha

Singh

et al. 2019

International Journal of Vascular Medicine

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Background Varicose veins are dilated, tortuous, superficial veins usually seen on lower limbs. Various surgical modalities are available for varicose veins including open surgery (Trendelenburg operation), Endovenous Laser Ablation (EVLA), Radiofrequency Ablation (RFA) and Sclerotherapy. The aim of this study is to look for the outcome of adjunct sclerotherapy for varicose veins done as an adjunct with Radio Frequency Ablation. Objective To know the possible outcome regarding benefits and complications of adjunct sclerotherapy with Radio Frequency Ablation. MethodologyWe combined Radio Frequency Ablation of varicose veins with necessary phlebectomy and perforator ligation and performed adjunct sclerotherapy for residual significant varicosities with polidocanol (2%) mixed with 2 ml NS and 2 cc of air (Tessari method) to patients undergoing varicose vein surgery in between 2016 and 2017. Records on complications were enquired immediately following surgery and on 1st follow up done within 3–5 days of the procedure. ResultsAmong 256 limbs subjected to varicose veins surgery 51 limbs were given adjunct sclerotherapy. Among them, five limbs had perivenous spillage with some localized swelling while there was allergic reaction in one patient as immediate postprocedural complication. Nine limbs had painful thrombosed veins during early follow-up. ConclusionsAdjunct sclerotherapy showed complication rate of roughly one tenth and one fifth of the treated cases in immediate and early postoperative follow-up.

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Foam sclerotherapy for lower-limb varicose veins: impact on saphenous vein diameter

Cited by 6 publications

References 15 publications

Foam‐in‐vein: A review of rheological properties and characterization methods for optimization of sclerosing foams

Foam‐in‐vein: A review of rheological properties and characterization methods for optimization of sclerosing foams

Efficacy and safety of polidocanol in the treatment of varicose veins of lower extremities

Short Term Outcome of Adjunct Foam Sclerotherapy for Varicose Veins in Patients Subjected to RFA at Dhulikhel Hospital, Nepal

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