Sclerosant foams

Abstract

SummaryNumerous ways of transferring detergent type liquid sclerosants into foam have been described. Out of all techniques, the three most commonly used around the world were selected. Sclerosant foams prepared with different agents and protocols were analyzed in detail, and their rheologic properties were assessed. Some of the results are presented in this review. Results: It is evident that the the material for foam production plays an important role for foam stability, and – connected to this – maybe also for efficacy and safety. Therefore, material that ensures acceptable foam quality should be used exclusively. Out of a huge number of possibilities, the material described in this study was found most suitable. This ensures minimal reduction of foam quality delivered into the vein. Foams considered instable are not clinically ineffective. They have a greater efficacy than the corresponding liquid agent. Foams considered stable seem to need lower injection volumes to have the same or better physical behaviour. Conclusion: Since higher volumes of sclerosant foams are correlated with more side effects, always the smallest effective volumes of foams of appropriate quality are justified.

Evidence of Foam Sclerotherapy in the Treatment of Recurrent Varicose Veins

“…Since the contemporary advent of sclerosing foams to treat venous insufficiency, several techniques and compounds have been tested to produce a highly effective air/gas-sclerosant mixture to maximize the contact area of the sclerosant with the endothelial surface [1]. The most commonly used technique combines the sclerosing compounds polidocanol (POL) or sodium tetradecyl sulphate (STS) as surfactants with air using the double-syringe Tessari method for foam preparation [2].…”

Effect of Hyaluronic Acid and Pluronic-F68 on the Surface Properties of Foam as a Delivery System for Polidocanol in Sclerotherapy

“…Varicose veins are formed by malfunctioning of vein valves causing blood reflux and swollen veins with blue or purple appearance in the legs. Sclerotherapy consists in the injection of sclerosing agents directly into the target vein [6][7][8][9]. The efficacy of the treatment depends mostly on the type of sclerosing agent and it has improved lately by recent vigorous experimental and clinical trials [10].…”

“…There are two main lines of action in the literature directed to improve the characteristics (foam stability and bubble size) of current sclerosing formulations: looking at the method of foam formation or the composition of the sclerosing solutions [9]. Concerning the method, there are various techniques available to generate sclerosing foams in the literature [5].…”