The destructive effects of sclerosant ethanolamine oleate on mammalian vessel endothelium

Abstract

Ethanolamine oleate (EO) used widely in sclerotherapy against esophageal varices was studied for its pharmacological effect on blood coagulation and vascular damage in animals. Blood coagulation was completely inhibited by EO at a concentration of 0.31%. EO destroyed the endothelial cells of the vessel of dog and rat within one minute after injection into the vessels. An accumulation of fibrin and platelets on the surface of the damaged vessel was observed electron microscopically. Mural thrombus was formed in a few hours and the thrombus occluded the blood stream in the vein. From these animal experiment, intravasal injection of EO was considered to cause the disappearance of varices by the following two processes: collapse of varices because of occlusion of the blood stream and shrinking of the obstructed thrombus through organization.

Venous malformation of the tongue in a child treated by sclerotherapy with ethanolamine oleate: a case report

“…The pharmacologic effect of EO is owing to the destruction of endothelial cells, accumulation of fibrin and platelets on the surface of the damaged vessel, occlusion of the blood stream, and shrinking of the obstructed thrombus through organization [3]. Possible complications of the sclerotherapy with EO include hemoglobinuria and hemolytic renal failure, but it has been reported that if the applied dose is less than 9.6 mL, these complications do not occur [5].…”

“…The sclerosing agent, EO, is a surfactant and has been used endoscopically in the treatment of esophageal varices [3,4]. The pharmacologic effect of EO is owing to the destruction of endothelial cells, accumulation of fibrin and platelets on the surface of the damaged vessel, occlusion of the blood stream, and shrinking of the obstructed thrombus through organization [3].…”

“…Direct injections of sclerosing agents such as absolute ethanol or polidocanol have often been reported to be successful in the treatment of VM [1,2]. A sclerosing agent, ethanolamine oleate (EO), has been used endoscopically in the treatment of esophageal varices and is reported to be safe and effective [3,4], so we used EO in the treatment of a huge VM arising in the tongue of a 3-year-old boy. The patient was successfully treated with direct injection of EO without problematic side effects.…”

Evaluation of endoscopic injection sclerotherapy with and without simultaneous ligation for the treatment of esophageal varices

“…The effectiveness of EIS by the intra-variceal injection method depends on the time that sclerosants at high concentration are in contact with endothelial cells in blood vessels. 11 With EISL, however, sclerosants are not diluted after release of the balloon and they work effec- tively because blood flow in the varix is completely interrupted by ligation of the injection site immediately after the injection of sclerosants. At the time we first used this method, we noted its marked effectiveness.…”

Long Term Results of Balloon-Occluded Retrograde Transvenous Obliteration for Portosystemic Shunt Encephalopathy in Patients with Liver Cirrhosis and Portal Hypertension

“…SRS is embolized and closed overnight, and the balloon catheter is removed on the next day. The dose of 5% EOI should be no more than 0.4 ml/kg per session of B-RTO to prevent complications such as renal dysfunction [11]. We apply the glucose push method (with 50% glucose solution) to advance the sclerosant to the side of the supplying vessel using as small a dose of 5% EOI as possible [12].…”