Sclerotherapy for Leg Telangiectasia—A Blinded Comparative Trial of Polidocanol and Hypertonic Saline

McCoy, Susanne E.; Evans, Anne M.; Bmbs,; Spurrier, Nicola

doi:10.1046/j.1524-4725.1999.08263.x

Cited by 48 publications

(33 citation statements)

References 11 publications

(19 reference statements)

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…Likewise, it has been used to sclerose telangiectasias. [122][123][124][125][126] The most recent interest in the use of hypertonic saline injection has been as an adjunct to RF energy; the injected hypertonic saline allows greater spread of the energy. In this regard, much work has been done by Hoey, Leveillee, and colleagues in the prostate.…”

Section: Rehman Et Al 96mentioning

confidence: 99%

See 1 more Smart Citation

Needle-Based Ablation of Renal Parenchyma Using Microwave, Cryoablation, Impedance- and Temperature-Based Monopolar and Bipolar Radiofrequency, and Liquid and Gel Chemoablation: Laboratory Studies and Review of the Literature

Rehman

Landman

Lee

et al. 2004

Journal of Endourology

View full text Add to dashboard Cite

"Needle-based ablation of renal parenchyma using microwave, cryoablation, impedance-and temperature-based monopolar and bipolar radiofrequency, and liquid and gel chemoablation: Laboratory studies and review of the literature." Journal of Endourology.18,1. 83-104. (2004 ABSTRACTBackground and Purpose: Small renal tumors are often serendipitously detected during the screening of patients for renal or other disease entities. Rather than perform a radical or partial nephrectomy for these diminutive lesions, several centers have begun to explore a variety of ablative energy sources that could be applied directly via a percutaneously placed needle-like probe. To evaluate the utility of such treatment for small renal tumors/masses, we compared the feasibility, regularity (consistency in size and shape), and reproducibility of necrosis produced in normal porcine kidneys by different modes of tissue ablation: microwaves, cold impedance-based and temperature-based radiofrequency (RF) energy (monopolar and bipolar), and chemical. Chemoablation was accomplished using ethanol gel, hypertonic saline gel, and acetic acid gel either alone or with simultaneous application of monopolar or bipolar RF energy. Materials and Methods: A total of 107 renal lesions were created laparoscopically in 33 domestic pigs. Microwave thermoablation (N 5 12) was done using a Targis T3 (Urologix) 10F antenna. Cryoablation (N 5 16) was done using a single 1.5-mm probe or three 17F microprobes (17F SeedNet™ system; Galil Medical) (N 5 10 single probe and N 5 6 three probes); a double freeze cycle with a passive thaw was employed under ultrasound guidance. Dry RF lesions were created using custom-made 18-gauge single-needle monopolar probe with two or three exposed metal tips (GelTx) (N 5 12) or a single-needle bipolar probe (N 5 6) at 50 W of 510 kHz RF energy for 5 minutes. In addition, a multitine RF probe (RITA Medical Systems) was used in one set of studies (N 5 6). Both impedance-and temperature-based RF were evaluated. Chemoablation was performed with 95% ethanol (4 mL), 24% hypertonic saline (4 mL), and 50% acetic acid (4 mL) as single injections. In addition, chemoablation was tested with monopolar and bipolar RF (wet RF). Tissues were harvested 1 week after ablation for light microscopy.Results: In 11 of the 15 ablation techniques, there was complete necrosis in all lesions; however, three ethanol gel lesions had skip areas, three hypertonic saline gel lesions showed no necrosis or injury, and one monopolar RF and one bipolar RF lesion showed skip areas. In contrast to impedance-based RF, heat-based RF (RITA) caused complete necrosis without skip areas. All cryolesions resulted in complete tissue necrosis, and cryotherapy was the only modality for which lesion size could be effectively monitored using ultrasound imaging.

show abstract

Section: Rehman Et Al 96mentioning

confidence: 99%

“…122,105 Hypertonic saline is helpful as it has a direct cytotoxic effect by virtue of its osmotic action, which causes cellular dehydration. We have used 23.4% saline in our studies, as the higher concentration minimizes the volume needed (e.g., 4 mL instead of 15-20 mL).…”

Section: Rehman Et Al 96mentioning

confidence: 99%

Needle-Based Ablation of Renal Parenchyma Using Microwave, Cryoablation, Impedance- and Temperature-Based Monopolar and Bipolar Radiofrequency, and Liquid and Gel Chemoablation: Laboratory Studies and Review of the Literature

Rehman

Landman

Lee

et al. 2004

Journal of Endourology

View full text Add to dashboard Cite

show abstract

“…Likewise, it has been used to sclerose telangiectasias. [151][152][153][154][155] The most recent interest in hypertonic saline injection has been as an adjunct to radiofrequency (RF) energy; the injected hypertonic saline allows for greater spread of the energy. In this regard, much work has been done by Hoey and Leveillee and their colleagues with prostate ablation, as discussed elsewhere in this issue.…”

Section: Hypertonic Salinementioning

confidence: 99%

Tissue Chemoablation

Rehman

Landman

Sundaram

et al. 2003

Journal of Endourology

View full text Add to dashboard Cite

To date, ethanol chemoablation has been shown to be feasible and reproducible only for metastatic hepatic carcinoma. In urology, chemoablation is still very much in the investigational stage for both the prostate and the kidney. A significant drawback is that even in the gel form, the spread of the chemoablative substance through the tissue is irregular and unpredictable. In the future, chemoablation may become a more effective modality by combining it with radiofrequency or other energy sources.

show abstract

“…To be maximally effective, HS must either be injected into an empty vein or displace blood from the vessel lumen as it contacts the endothelium. 5 …”

Section: A B C D E Fmentioning

confidence: 99%

“…HS and the FDA-approved sclerosants are associated with a high incidence of necrotic ulceration resulting from extravasation, as well as with postsclerosis hyperpigmentation. [5][6][7] Polidocanol Polidocanol was developed in the early 1950s for use as a local anesthetic, but it was soon noted that intravascular and even intradermal instillation of the agent produced sclerosis of small-diameter blood vessels; for this reason, it was no longer used as a local anesthetic. The agent's anesthetic properties prevent it from causing pain on injection, so patient comfort is maintained during the sclerotherapy session.…”

mentioning

confidence: 99%

0.5% polidocanol for treatment of varicose veins

Collini¹

2000

Aesthetic Surgery Journal

View full text Add to dashboard Cite

show abstract

Sclerotherapy for Leg Telangiectasia—A Blinded Comparative Trial of Polidocanol and Hypertonic Saline

Abstract: 20% HS and 1% POL have equal efficacy in sclerosing leg telangiectasia and reticular feeding veins. POL causes more adverse sequelae, although these may be related to the solution concentration.

Cited by 48 publications

References 11 publications

Needle-Based Ablation of Renal Parenchyma Using Microwave, Cryoablation, Impedance- and Temperature-Based Monopolar and Bipolar Radiofrequency, and Liquid and Gel Chemoablation: Laboratory Studies and Review of the Literature

Needle-Based Ablation of Renal Parenchyma Using Microwave, Cryoablation, Impedance- and Temperature-Based Monopolar and Bipolar Radiofrequency, and Liquid and Gel Chemoablation: Laboratory Studies and Review of the Literature

Tissue Chemoablation

0.5% polidocanol for treatment of varicose veins

Contact Info

Product

Resources

About