Ultrasound-guided foam sclerotherapy for the treatment of primary varicose veins

Bountouroglou, D.; Geroulakos, George

doi:10.1258/0268355041753407

Cited by 4 publications

(2 citation statements)

References 7 publications

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“… 6 This, in turn, increases the safety of foam treatment as shown in clinical trials. 7 – 9 Furthermore, foam is echogenic, which improves visibility and treatment accuracy. 10 Also, foam treatment can be performed in an outpatient setting without need for sedation or tumescent anesthesia.…”

Section: Introductionmentioning

confidence: 99%

Benefits of polidocanol endovenous microfoam (Varithena®) compared with physician-compounded foams

et al. 2015

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ObjectiveTo compare foam bubble size and bubble size distribution, stability, and degradation rate of commercially available polidocanol endovenous microfoam (Varithena®) and physician-compounded foams using a number of laboratory tests.MethodsFoam properties of polidocanol endovenous microfoam and physician-compounded foams were measured and compared using a glass-plate method and a Sympatec QICPIC image analysis method to measure bubble size and bubble size distribution, Turbiscan™ LAB for foam half time and drainage and a novel biomimetic vein model to measure foam stability. Physician-compounded foams composed of polidocanol and room air, CO2, or mixtures of oxygen and carbon dioxide (O2:CO2) were generated by different methods.ResultsPolidocanol endovenous microfoam was found to have a narrow bubble size distribution with no large (>500 µm) bubbles. Physician-compounded foams made with the Tessari method had broader bubble size distribution and large bubbles, which have an impact on foam stability. Polidocanol endovenous microfoam had a lower degradation rate than any physician-compounded foams, including foams made using room air (p < 0.035). The same result was obtained at different liquid to gas ratios (1:4 and 1:7) for physician-compounded foams. In all tests performed, CO2 foams were the least stable and different O2:CO2 mixtures had intermediate performance. In the biomimetic vein model, polidocanol endovenous microfoam had the slowest degradation rate and longest calculated dwell time, which represents the length of time the foam is in contact with the vein, almost twice that of physician-compounded foams using room air and eight times better than physician-compounded foams prepared using equivalent gas mixes.ConclusionBubble size, bubble size distribution and stability of various sclerosing foam formulations show that polidocanol endovenous microfoam results in better overall performance compared with physician-compounded foams. Polidocanol endovenous microfoam offers better stability and cohesive properties in a biomimetic vein model compared to physician-compounded foams. Polidocanol endovenous microfoam, which is indicated in the United States for treatment of great saphenous vein system incompetence, provides clinicians with a consistent product with enhanced handling properties.

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Section: Introductionmentioning

confidence: 99%

Benefits of polidocanol endovenous microfoam (Varithena®) compared with physician-compounded foams

et al. 2015

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“…A ocorrência de complicações respiratórias em decorrência da ecoescleroterapia com microespuma não foi detectada 18 . A avaliação pulmonar por cintilografia, após a perfusão venosa de 10 ml de microespuma, não detectou alteração alguma 19 .…”

Section: Discussionunclassified

Ecoescleroterapia com microespuma em varizes tronculares primárias

Figueiredo

Araújo²,

Penha-Silva

2006

J. vasc. bras.

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177 ResumoObjetivo: Avaliar o tratamento de varizes tronculares primárias por ecoescleroterapia com microespuma.Métodos: A amostra foi constituída de 25 membros de seis pacientes do sexo masculino e 19 do sexo feminino, com incompetência das veias safenas magna (21 membros) ou parva (quatro membros). Eles foram avaliados de acordo com a classificação clínica, etiológica, anatômica e fisiopatológica (CEAP) e classificados nos graus C 3 (10 membros), C 4 (seis membros), C 5 (cinco membros) e C 6 (quatro membros). A microespuma (5 ml), preparada pela mistura de 1 ml de polidocanol a 3% e 5 ml de ar, era injetada na veia do paciente, em posição de Trendelenburg, com monitoração por ultra-sonografia com Doppler colorido. Os membros eram enfaixados com atadura inelástica por 3 dias; depois disso, os pacientes usavam meias elásticas, 30-40 mmHg, 3/4 ou 7/8, durante 3 meses. A eficiência do tratamento foi avaliada pelo escore clínico da classificação CEAP para dor, edema e claudicação e pelas alterações ultra-sonográficas 12 meses depois. Os escores clínicos antes e depois do tratamento foram comparados pelo teste de Wilcoxon.Resultados: Houve diminuição significante nos escores clínicos (P < 0,05) e sucesso terapêutico, com oclusão total e recanalização parcial sem refluxo, em 84% dos casos. Do total, 16% dos casos apresentaram recanalização parcial, com refluxo, ou recanalização completa.Conclusão: A ecoescleroterapia, método simples, de baixo custo, que dispensa internação e anestesia, mostrou ser promissora no tratamento de varizes tronculares primárias.Palavras-chave: Escleroterapia, varizes, polidocanol, ultrasonografia por Doppler colorido. AbstractObjective: To evaluate the treatment of primary trunk varicose veins by microfoam ultrasound-guided sclerotherapy.Methods: The sample was composed of 25 members of six male and 19 female patients, with incompetence of great saphenous vein (21) and short saphenous vein (4). Patients were assessed according to the clinical, etiologic, anatomical and pathophysiological (CEAP) classification and divided into degrees C 3 (10), C 4 (6), C 5 (5) and C 6 (4). With the patients in the Trendelenburg position, microfoam (5 ml), prepared by mixture of 1 ml polidocanol at 3% and 5 ml of air, was injected in their vein and monitored by color-flow Doppler ultrasonography. The members were then swaddled with inelastic bandage for 3 days; afterward, the patients used 30-40 mmHg, 3/4 or 7/8, elastic socks, during 3 months. Treatment efficiency was evaluated based on the CEAP classification for pain, edema and claudication, and on color-flow Doppler ultrasonographic changes 12 months later. Clinical scores, before and after treatment, were compared using the Wilcoxon test.Results: There was a significant decrease in the clinical scores (p < 0.05). Therapeutic success was achieved, with total occlusion and partial recanalization without reflux in 84% of the cases. The remaining 16% of the cases presented partial recanalization with reflux or complete recanalization.Conclusion: Ultrasound-...

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