Reversible Cardiac Arrest After Polidocanol Sclerotherapy of Peripheral Venous Malformation

Marrocco-Trischitta, Massimiliano M.; Guerrini, P; Abeni, Damiano; Stillo, Francesco

doi:10.1097/00042728-200202000-00011

Cited by 27 publications

(40 citation statements)

References 8 publications

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“…Until now, very few severe systemic complications have been reported, including cardiac complications, neurologic deficits, pulmonary embolism, and stroke [46,[49][50][51][52][53]. In our study, one patient (patient 1) experienced a complication.…”

Section: Discussionmentioning

confidence: 57%

“…According to the manufacturer's guidelines, the maximum daily dose of polidocanol based on body weight is 2 mg/kg/day [45]. Theoretically, systemic complications such as cardiotoxicity can occur after the systemic diffusion of polidocanol, when it passes into the systemic circulation from the injection site, such as during varicose vein treatment [46]. However, in BRTO, polidocanol has no chance to pass into the systemic circulation from the injection site.…”

Section: Discussionmentioning

confidence: 99%

“…Among the complications, cardiotoxiticty is related to the local anesthetic properties of polidocanol, and this is proportional to the patient's blood levels, not solely the dose [54]. However, the incidence of this complication is extremely rare [46,55,56]. Stroke is related to the underlying patent foramen ovale [51,52], and the neurologic deficit is transient [53].…”

Section: Discussionmentioning

confidence: 99%

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Foam sclerotherapy using polidocanol for balloon-occluded retrograde transvenous obliteration (BRTO)

et al. 2010

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Section: Discussionmentioning

confidence: 57%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

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Foam sclerotherapy using polidocanol for balloon-occluded retrograde transvenous obliteration (BRTO)

et al. 2010

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“…Polidocanol is a nonionic detergent sclerosing agent. Its detergent action induces a rapid overhydration of endothelial cells, leading to vascular injury [24]. The current study indicated that polidocanol sclerotherapy has significant efficacy in pain relief in patients with painful VMs.…”

Section: Discussionmentioning

confidence: 59%

“…To prevent adverse reactions, excessive usage of polidocanol should be avoided. Marrocco-Trischitta et al [24] reported one incident of reversible cardiac arrest in a 5-year-old patient with a VM following injection of 4 mL of 1% polidocanol. Cardiac complications following polidocanol injections are extremely rare, but they can occur owing to the anesthetic properties of polidocanol [24].…”

Section: Discussionmentioning

confidence: 99%

Polidocanol sclerotherapy for painful venous malformations: evaluation of safety and efficacy in pain relief

et al. 2009

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The aim of this study was to retrospectively evaluate the safety and efficacy of polidocanol sclerotherapy in pain relief for painful venous malformations (VMs). Thirty-one patients with painful VMs underwent polidocanol sclerotherapy. Pain intensity was assessed with an 11-point verbal numerical rating scale. Sclerotherapy was technically successful in 58 (98.3%) of 59 sessions. Twenty-six (89.7%) out of 29 patients experienced an improvement in pain after sclerotherapy at follow-up, a mean of 46 months after treatment. The mean pain score improved from 6.6 + or - 2.5 before treatment to 2.4 + or - 2.9 after treatment (P <.001). The factors that significantly influenced the therapeutic effect were size of lesion (P = .008), margin of lesion (P = .006), and stasis of sclerosant (P = .032). Adverse events included hypotension and bradycardia during the procedure. No major complication occurred. Polidocanol sclerotherapy is safe and most efficacious in providing pain relief for patients with small VMs (equal to or less than 10 cm in diameter), VMs with a well-defined margin, and VMs with good stasis of sclerosant during sclerotherapy.

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Sclerotherapy for Reticular Veins in the Lower Limbs

et al. 2017

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IMPORTANCE Reticular veins are subdermal veins located in the lower limbs and are mainly associated with aesthetic complaints. Although sclerotherapy is the treatment of choice for reticular veins in the lower limbs, no consensus has been reached regarding to the optimal sclerosant.OBJECTIVE To compare the efficacy and safety of 2 sclerosants used to treat reticular veins: 0.2% polidocanol diluted in 70% hypertonic glucose (HG) (group 1) vs 75% HG alone (group 2). DESIGN, SETTING, AND PARTICIPANTS Prospective, randomized, triple-blind, controlled, parallel-group clinical trial with patients randomly assigned in a 1:1 ratio between the 2 treatment groups from March through December 2014, with 2 months' follow-up. The study was conducted in a single academic medical center. Eligible participants were all women, aged 18 to 69 years, who had at least 1 reticular vein with a minimum length of 10 cm in 1 of their lower limbs. INTERVENTIONSThe patients underwent sclerotherapy in a single intervention with either 0.2% polidocanol plus 70% HG or 75% HG alone to eliminate reticular veins. MAIN OUTCOMES AND MEASURESThe primary efficacy end point was the disappearance of the reticular veins within 60 days after treatment with sclerotherapy. The reticular veins were measured on images obtained before treatment and after treatment using ImageJ software. Safety outcomes were analyzed immediately after treatment and 7 days and 60 days after treatment and included serious adverse events (eg, deep vein thrombosis and systemic complications) and minor adverse events (eg, pigmentation, edema, telangiectatic matting, and hematomas).RESULTS Ninety-three women completed the study, median (interquartile range) age 43.0 (24.0-61.0) years for group 1 and 41.0 (27.0-62.0) years for group 2. Sclerotherapy with 0.2% polidocanol plus 70% HG was significantly more effective than with 75% HG alone in eliminating reticular veins from the treated area (95.17% vs 85.40%; P < .001). No serious adverse events occurred in either group. Pigmentation was the most common minor adverse event, with a 3.53% treated-vein pigmentation length for group 1 and 7.09% for group 2, with no significant difference between the groups (P = .09).CONCLUSIONS AND RELEVANCE Sclerotherapy with 0.2% polidocanol diluted in 70% HG was superior to 75% HG alone in sclerosing reticular veins, with no statistical difference for complications. Pigmentation occurred in both groups, with no statistical difference between them. No serious adverse events occurred in either group. TRIAL REGISTRATION clinicaltrials.gov Identifier: NCT02054325

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Reversible Cardiac Arrest After Polidocanol Sclerotherapy of Peripheral Venous Malformation

Cited by 27 publications

References 8 publications

Foam sclerotherapy using polidocanol for balloon-occluded retrograde transvenous obliteration (BRTO)

Foam sclerotherapy using polidocanol for balloon-occluded retrograde transvenous obliteration (BRTO)

Polidocanol sclerotherapy for painful venous malformations: evaluation of safety and efficacy in pain relief

Sclerotherapy for Reticular Veins in the Lower Limbs

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