Middle cerebral air embolism after foam sclerotherapy

Rogers, Campbell; Russell, Bianca

doi:10.1258/phleb.2011.011002

Cited by 18 publications

(16 citation statements)

References 10 publications

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“…PPVA is a means of right-to-left shunt, which may result in systemic arterial embolization when foam sclerosants, or particle-like embolic materials, are injected into these collateral channels. Until now, there have been 9 reports of serious cerebrovascular events associated with the treatment of varicose veins using foam sclerotherapy ( 21 ), and paradoxical embolization caused by N-butyl-cyanoacrylate during the treatment of gastric varices ( 22 23 ).…”

Section: Discussionmentioning

confidence: 99%

Efficacy and Safety of Balloon-Occluded Retrograde Transvenous Obliteration with Sodium Tetradecyl Sulfate Liquid Sclerotherapy

et al. 2016

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ObjectiveTo evaluate the efficacy and safety of balloon-occluded retrograde transvenous obliteration (BRTO) with sodium tetradecyl sulfate (STS) liquid sclerotherapy of gastric varices.Materials and MethodsBetween February 2012 and August 2014, STS liquid sclerotherapy was performed in 17 consecutive patients (male:female = 8:9; mean age 58.6 years, range 44–86 years) with gastric varices. Retrograde venography was performed after occlusion of the gastrorenal shunt using a balloon catheter and embolization of collateral draining veins using coils or gelfoam pledgets, to evaluate the anatomy of the gastric varices. We prepared 2% liquid STS by mixing 3% STS and contrast media in a ratio of 2:1. A 2% STS solution was injected into the gastric varices until minimal filling of the afferent portal vein branch was observed (mean 19.9 mL, range 6–33 mL). Patients were followed up using computed tomography (CT) or endoscopy.ResultsTechnical success was achieved in 16 of 17 patients (94.1%). The procedure failed in one patient because the shunt could not be occluded due to the large diameter of gastrorenal shunt. Complete obliteration of gastric varices was observed in 15 of 16 patients (93.8%) with follow-up CT or endoscopy. There was no rebleeding after the procedure. There was no procedure-related mortality.ConclusionBRTO using STS liquid can be a safe and useful treatment option in patients with gastric varices.

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Section: Discussionmentioning

confidence: 99%

Efficacy and Safety of Balloon-Occluded Retrograde Transvenous Obliteration with Sodium Tetradecyl Sulfate Liquid Sclerotherapy

et al. 2016

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“…[1] Complications related to sclerotherapy are extremely rare [2,8] and may not only be dependent on chemical irritation or iatrogenic factors; however, they also be related with patients related factors such as hypercoagulable state. [9] There have been a number of case reports in the past about development of sclerotherapy-related severe life threatening complications including acute ischemic stroke in a 73-year-old woman, [10] myocardial infarction in a 61-year-old patient with foramen ovale, [11] arterial occlusion due to intra-arterial injection in a 59-year-old woman, [12] middle cerebral arterial embolism, [13] and visual loss in a 66-year-old woman. [14] It is likely that foam sclerotherapy in elderly may rarely cause serious complications, while related complications are usually mild, transient and underreported.…”

Section: Discussionmentioning

confidence: 99%

Histopathological findings of an excised varicose vein complicated with chemical phlebitis

Yılmaz¹

2014

Cardiovascular Surgery and Interventions

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Sclerotherapy aims to obliterate the varicose veins after injection of the sclerosing substance into vein lumen by causing stenosis, fibrosis and thrombosis through endothelial cell damage, spasm and inflammatory reaction mechanisms. However, there is a limited number of studies investigating the histopathological effects of sclerotherapy to the human veins. In this case report, we evaluated the histopathological results of the in vivo liquid sclerotherapy [Lauromacrogol 400 (40 mg-2% Aethoxysklerol)] on a vein wall specimen surgically excised after development of a painful and non-resorbing thrombus.

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“…From 1994 to 2015, 16 cases of stroke were published. 2,[5][6][7] Thoracic symptoms, such as oppression and cough, have also been reported after foam sclerotherapy. When air is used, the incidence of those symptoms varies from 16 to 18%, while with CO 2 , from 1.6 to 3.1%.…”

Section: Introductionmentioning

confidence: 99%

Effect of polidocanol foam administration into rat peripheral veins on pulmonary parenchyma

et al. 2017

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Background Sclerotherapy has been gaining increased acceptance and popularity as an effective therapy for the treatment of varicose veins. This attention has fed growing interest into the safety and potential complications of this procedure. There is no evidence of pulmonary complications from foam sclerotherapy in humans; however, animal studies have shown possible damage. The aim of this study is to show the changes in rat pulmonary parenchyma after the injection of 1% polidocanol Tessari foam into the peripheral vein using histological analysis of the inflammatory and fibrosis processes. Methods Twenty-four Wistar rats were divided into the following four groups: 24 h polidocanol, seven-day polidocanol, 28-day polidocanol, and control group. After the foam was injected into the lateral saphenous vein, the lungs of the rats were removed for histological analysis. Results Alveolar edema was observed in only the 24 h group (P < 0.005). Vessel thickening was observed in the seven-and 28-day groups (P < 0.001). Interstitial fibrosis was found in only the 28-day group (P = 0.006). There was no evidence of venous or arterial thrombosis in either group. Conclusion Polidocanol Tessari foam injection into rat peripheral veins causes alveolar edema, vessel thickening, and interstitial fibrosis.

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Middle cerebral air embolism after foam sclerotherapy

Cited by 18 publications

References 10 publications

Efficacy and Safety of Balloon-Occluded Retrograde Transvenous Obliteration with Sodium Tetradecyl Sulfate Liquid Sclerotherapy

Efficacy and Safety of Balloon-Occluded Retrograde Transvenous Obliteration with Sodium Tetradecyl Sulfate Liquid Sclerotherapy

Histopathological findings of an excised varicose vein complicated with chemical phlebitis

Effect of polidocanol foam administration into rat peripheral veins on pulmonary parenchyma

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