Sclerotherapy of telangiectasias or spider veins in the lower limb: A review

Thomson, Lily

doi:10.1016/j.jvn.2016.04.002

Cited by 10 publications

(3 citation statements)

References 18 publications

(29 reference statements)

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“…While details of the pathophysiology of spider veins are still unknown, former work of our group revealed that chronic elevation of the venous pressure is sufficient to drive venous remodeling in mice (Feldner et al, 2011 ; Pfisterer et al, 2014a ; Kuk et al, 2017 ). In fact, some reports hypothesize that telangiectasias may arise from varicose veins of larger vessels due to venous hypertension caused by valvular damage resulting in reflux and venous dilatation (Thomson, 2016 ). With reference to the law of Laplace, elevated pressure levels result in an increase in wall stress or biomechanical (over)load of the venous vessel wall within the affected venous network to drive its further remodeling (Partsch, 2009 ; Atta, 2012 ).…”

Section: Introductionmentioning

confidence: 99%

Glycyrrhetinic Acid Antagonizes Pressure-Induced Venous Remodeling in Mice

et al. 2018

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Development of spider veins is caused by the remodeling of veins located in the upper dermis and promoted by risk factors such as obesity or pregnancy that chronically increase venous pressure. We have repeatedly shown that the pressure-induced increase in biomechanical wall stress is sufficient to evoke the formation of enlarged corkscrew-like superficial veins in mice. Subsequent experimental approaches revealed that interference with endothelial- and/or smooth muscle cell (SMC) activation counteracts this remodeling process. Here, we investigate whether the herbal agent glycyrrhetinic acid (GA) is a suitable candidate for that purpose given its anti-proliferative as well as anti-oxidative properties. While basic abilities of cultured venous SMCs such as migration and proliferation were not influenced by GA, it inhibited proliferation but not angiogenic sprouting of human venous endothelial cells (ECs). Further analyses of biomechanically stimulated ECs revealed that GA inhibits the DNA binding capacity of the mechanosensitive transcription factor activator protein-1 (AP-1) which, however, had only a minor impact on the endothelial transcriptome. Nevertheless, by decreasing gelatinase activity in ECs or mouse veins exposed to biomechanical stress, GA diminished a crucial cellular response in the context of venous remodeling. In line with the observed inhibitory effects, local transdermal application of GA attenuated pressure-mediated enlargement of veins in the mouse auricle. In summary, our data identifies GA as an inhibitor of EC proliferation, gelatinase activity and venous remodeling. It may thus have the capacity to attenuate spider vein formation and remodeling in humans.

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Section: Introductionmentioning

confidence: 99%

Glycyrrhetinic Acid Antagonizes Pressure-Induced Venous Remodeling in Mice

et al. 2018

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“…Setting realistic expectations for patients relieves anxiety and enables a positive treatment experience. 178 Few postsclerotherapy or thrombophlebitis complications are observed in ulcers, while hyperpigmentation is the most frequent minor adverse event. 179,185 Though there is no clear evidence of superiority among sclerosants, superior results tend to be observed with the use of a detergent (such as polidocanol) compared to the use of a hypertonic agent (such as 75% glucose) alone.…”

Section: Treatment Of Small Vesselsmentioning

confidence: 99%

Brazilian guidelines on chronic venous disease of the Brazilian Society of Angiology and Vascular Surgery

Kikuchi,

Nhuch,

Drummond

et al. 2023

J. vasc. bras.

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The Brazilian Society of Angiology and Vascular Surgery has set up a committee to provide new evidence-based recommendations for patient care associated with chronic venous insufficiency. Topics were divided in five groups: 1. Classification, 2. Diagnosis, 3. Conservative or non-invasive treatment, 4. Invasive treatment and 5. Treatment of small vessels. This last series is closely related to the activities of Brazilian angiologists and vascular surgeons, who are heavily involved in the treatment of small superficial veins. These guidelines are intended to assist in clinical decision-making for attending physicians and health managers. The decision to follow a guideline recommendation should be made by the responsible physician on a case-by-case basis taking into account the patient's specific condition, as well as local resources, regulations, laws, and clinical practice recommendations.

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“…However, TM may also occur in the absence of venous disease and in patients with no previous venous interventions. 5,6 The present study had two parts. First a retrospective analysis of 352 consecutive patients was performed to identify risk factors for TM.…”

Section: Introductionmentioning

confidence: 99%

Telangiectatic Matting is Associated with Hypersensitivity and a Bleeding Tendency

Kadam

Lim

Paver

et al. 2018

European Journal of Vascular and Endovascular Surgery

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TM is associated with both hypersensitivity and a bleeding tendency. This study revealed no significant increase in the incidence of haemostatic abnormalities in patients with TM compared with the control group. Given the significant association with hypersensitivity disorders, the underlying mast cell hyper-reactivity may contribute to both hypersensitivity and a bleeding tendency and predispose patients to TM.

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Sclerotherapy of telangiectasias or spider veins in the lower limb: A review

Cited by 10 publications

References 18 publications

Glycyrrhetinic Acid Antagonizes Pressure-Induced Venous Remodeling in Mice

Glycyrrhetinic Acid Antagonizes Pressure-Induced Venous Remodeling in Mice

Brazilian guidelines on chronic venous disease of the Brazilian Society of Angiology and Vascular Surgery

Telangiectatic Matting is Associated with Hypersensitivity and a Bleeding Tendency

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