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Acta Phlebologica 2001 April;2(1):43-9

Copyright © 2001 EDIZIONI MINERVA MEDICA

language: English, Italian

Postsclerotherapy occurrance of hyperpigmentation and other local and systemical signs in the treatment of small vessels varices with different sclerotherapic agents. Preliminary report

Santoro P. 1, Blandamura M. 1, Chiti D. 2, Scaramuzzino L. 3

1 Clinica Angiomedica - Roma; 2 Ambulatorio Angiologico - Prato (Firenze); 3 Università degli Studi - Catanzaro, Scuola di Specializzazione in Chirurgia Vascolare, AO NA1 Ospedale Loreto Mare


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BACKGROUND: To determine the safe­ty of a ­short ­term use of pur­i­fied sodi­um tet­ra­dec­yl sul­phate in ­form of ­water solu­tion or ­foam ­obtained accord­ing to Tessari’s meth­od in the treat­ment of ­small ves­sels varic­es.
METHODS: One hun­dred and two ­patients of ­which 18 ­male and 84 ­female of ­about 38 mid­dle age ­were treat­ed for 3 ­months ­with 3 dif­fer­ent scler­o­sant ­agents pur­i­fied sodi­um tet­ra­dec­yl sul­phate, chro­mat­ed gly­ce­rin, phol­i­doc­a­nol in telan­giec­tas­es and retic­u­lar ­veins. Each ­patient ­received 8 scle­roth­e­rap­ic treat­ments and the 3 scler­o­sant ­agents ­were ­used in ­form of ­water solu­tion or ­foam begin­ning ­from ­known con­cen­tra­tions and dilut­ed at ­desired con­cen­tra­tions ­using a ­water 2% solu­tion of car­bo­caine or phys­io­log­ic solu­tion.
RESULTS: In all the ­patients treat­ed ­with the ­three dif­fer­ent scler­o­sant ­agents, ­there ­were not iso­lat­ed ­signs of escha­ra; ­there ­were 2 cas­es of ear­ly hyper­pig­men­ta­tions (2% of the cas­es treat­ed) ­with the use of pur­i­fied sodi­um tet­ra­dec­yl sul­phate, 4 cas­es (3.9% of the cas­es treat­ed) ­with the use of chro­mat­ed gly­ce­rin and 5 cas­es (4.9%) ­with the use of phol­i­doc­a­nol; ­there ­were iso­lat­ed 2 cas­es (2%) of ­local ­signs of aller­gy ­with the use of pur­i­fied sodi­um tet­ra­dec­yl sul­phate, 6 cas­es (5.9%) ­with the use of chro­mat­ed gly­ce­rin and 8 cas­es (6.8%) ­with the use of phol­i­doc­a­nol; the ­patient’s com­pli­ance was ­good in 97 cas­es (95.1%) ­with the use of pur­i­fied sodi­um tet­ra­dec­yl sul­phate and ­good in 92 cas­es (90.2%) ­with the use of ­both chro­mat­ed gly­ce­rin and phol­i­doc­a­nol. Finally, cas­es of hyper­sen­si­tiv­ity and system­i­cal­ly aller­gy ­signs (anaph­y­lax­is) asso­ciat­ed ­with the use of ­these ­three dif­fer­ent scler­o­sants ­were not ­observed.
CONCLUSIONS: Sodium pur­i­fied tet­ra­dec­yl sul­phate has ­shown to be a scler­o­sant ­agent ­with a ­high safe­ty ­index in the treat­ment of ­small ves­sels varic­es ­both in ­water solu­tion or ­foam, espe­cial­ly for the inci­dence of cuta­ne­ous ­signs of esthet­i­cal inter­est (ear­ly hyper­pig­men­ta­tion and telan­giec­tat­ic mat­ting, ­local aller­gic ­signs) and for the ­patient’s com­pli­ance com­pared ­with the ­most ­employed and ­safe scler­o­sant ­agents actu­al­ly avail­able in ther­a­py. The use of ­foam can ­also high­ly ­reduce the con­cen­tra­tion and the vol­ume of the scle­ros­ing ­drug to use, so ­that the inci­dence of ­local ­signs of inflam­ma­tion, ­eschar, ­pain ­after treat­ment and hyp­er pig­men­ta­tions is low­er.

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