Amount Of Sclerosant Research Articles

Red dichromatic imaging reduces endoscopic treatment time of esophageal varices by increasing bleeding point visibility (with video).

Red dichromatic imaging (RDI) is a novel image-enhanced endoscopy released in 2020, which increases the visibility of deeper vessels. In this study, we retrospectively investigated whether RDI can shorten treatment times of endoscopic injection sclerotherapy (EIS), and which operational procedure times are affected compared with white light imaging (WLI). A total of 155 patients (RDI, 70; WLI, 85) with risky esophageal varices (EV), who were treated with EIS were analyzed. Treatment times were compared, and predictors associated with treatment time were analyzed by multivariate analysis. For 24 cases (RDI, 12; WLI, 12) in which treatment videos were recorded, the procedure times of each step (observation of EV, needle flush, positioning, puncture, observation of bleeding, hemostasis, observation after hemostasis) were measured. Regarding the seven patients with EV bleeding, color differences were calculated between the bleeding point and the blood pool using the CIE (L*a*b*) color measurement method, and results were compared between using RDI and WLI. Treatment times were shorter in the RDI group (RDI vs. WLI = 35.1 vs. 42.2 min; P < 0.01). 'RDI function' and 'amount of sclerosant' were extracted as independent predictors of treatment time. Times for 'observation of EV' and 'observation of bleeding' were shorter in the RDI group (P = 0.01 and <0.01, respectively). Regarding the color difference, RDI significantly increased bleeding point visibility (RDI vs. WLI = 31.4 ± 11.8 vs. 8.6 ± 6.2, P < 0.001). Red dichromatic imaging can shorten the treatment time of EIS by increasing bleeding point visibility.

Preliminary experience with promethazine hydrochloride injection in the sclerotherapy of oral mucocele

Mucoceles are common in the minor salivary and sublingual glands. Sclerotherapy is a possible treatment strategy for mucoceles. The purpose of this study was to evaluate the clinical outcomes of sclerotherapy with promethazine hydrochloride injection in treating mucoceles. Thirty-seven patients were enrolled. Sclerotherapy was performed with promethazine hydrochloride injection (25mg/ml) through the mucosa. Patients were followed up at 1, 3, and 6 months after the last sclerotherapy. Clinical data were reviewed. The lesions (range 2–30mm in diameter) occurred on the ventral tongue tip (20 patients), lower lip (11 patients), and floor of the mouth (six patients). The amount of sclerosant per injection ranged from 0.2ml to 1ml. At the 6-month follow-up, 33 patients showed resolution with no recurrence. One patient showed a significant response with a 5-mm-diameter nodule remaining after two sclerotherapies. Three patients who underwent two or more sclerotherapies failed to show an improvement. The overall cure rate was 91.9% (96.8% for mucoceles of the minor salivary gland, 66.7% for ranulas). Complications were rare and mild. Sclerotherapy with promethazine hydrochloride injection for the treatment of mucoceles is safe. It is effective for mucoceles of the minor salivary glands, but its application for ranulas requires further investigation.

The Prevalence, Risk Factors, and Clinical Outcome of Balloon Rupture in Balloon-occluded Retrograde Transvenous Obliteration of Gastric Varices

To evaluate the prevalence, risk factors, and clinical outcome after balloon rupture during balloon-occluded retrograde transvenous obliteration (BRTO). Sixty-nine patients who underwent the BRTO procedure from August 1999 to January 2009 were analyzed retrospectively. The occurrence of balloon rupture was recorded by a review of medical records and imaging studies. The chi(2) test was used to analyze risk factors for balloon rupture including balloon type and size, amount of sclerosant, and the use of microcatheters. The influence of balloon rupture on migration of the sclerosant and in-hospital mortality was analyzed with the Fisher exact test. The prevalence of balloon rupture was 8.7% (six of 69 patients). No significant risk factor for balloon rupture was identified because of the small number of balloon rupture cases. Migration of the sclerosant occurred in three patients with early balloon rupture within 1 hour. One of these patients died of recurrent gastric variceal bleeding and another experienced dyspnea and died of fungal sepsis. Among the 63 patients without rupture, no migration of the sclerosant was noted, and one patient died of sepsis caused by liver abscess. Incidences of sclerosant migration and in-hospital mortality were significantly higher in patients with balloon rupture versus patients without balloon rupture (P = .018 and P < .001, respectively). Balloon rupture during BRTO occurred in 8.7% of patients. Balloon rupture may cause rapid migration of sclerosant, pulmonary embolism, and recurrent gastric variceal bleeding.

Compression sclerotherapy of anterolateral thigh primary varicose veins (lateral accessory saphenous varicose veins): a prospective five-year follow-up study

Aim: To determine the percentage of varicose vein recurrence after compression sclerotherapy of a specific primary varicose vein, the anterolateral thigh vein (lateral accessory saphenous vein), without saphenofemoral junction (SFJ) incompetence at yearly intervals in a long-term follow-up study, and to investigate factors influencing recurrence. Patients and methods: Of 117 patients recruited, 11 were lost to follow up; therefore 106 patients were evaluated: 97 women, mean age 42 years (range 21-72) and nine men, mean age 47 years (range 21-67). If SFJ incompetence was present, surgical ligation of the junction was performed. Primary varicose veins were treated with compression sclerotherapy using polidocanol. A total of 111 limbs were studied. Results: Recurrent varicose veins were found after six months in 6% of cases, after one year in 18% (cumulative percentage), after two years in 28%, after three years in 36%, after four years in 46%and after five years in 54%. No differences could be detected between the recurrence group and the group without recurrence regarding length of varicose veins, amount of polidocanol used, number of injections, circumference of the leg or age of the patient. The varicose vein diameter was significantly larger in the recurrence group. Conclusions: Compression sclerotherapy with polidocanol of the anterolateral thigh vein (lateral accessory saphenous vein) without SFJ incompetence results in a high recurrence rate. Recurrence depends only on the vessel diameter, and not on the length of the varicose vein, amount of sclerosant used or patient age.

Tetracycline sclerotherapy for testicular hydroceles in renal transplant recipients

Objectives. To study the efficacy of tetracycline sclerotherapy in renal transplantrecipients with symptomatic hydroceles. Methods. A total of 21 patients with symptomatic hydroceles following renal transplantationunderwent aspiration of hydrocele and injection of tetracycline hydrochloride. Sclerosant solution was prepared by dissolving 1 g tetracycline hydrochloride powder in 10 mL 1 % lidocaine. The amount of sclerosant used depended on the volume of the sac: 5 mL for a sac containing up to 100 mL and 2.5 mL of sclerosant was added for each increase of 100 mL in sac volume. Results. Twelve patients (57%) required only one treatment and 9 patients (43%) hadup to 3 injections. The larger the hydrocele, the more treatments were required. The resolution of hydrocele was complete in 12 patients (57%) and partial in 7 (33%) with 2 (10%) failures. Pain at injection was observed in one third of the patients. No major complications (fever, hematoma, infections, abscess, or scrotal necrosis) occurred in any patient. No changes in the structure or size of the testicles were found by ultrasound during an average follow-up period of 35 months. Conclusions. Tetracycline sclerotherapy is a safe, effective, and economical form of outpatienttherapy that can be recommended as primary treatment for hydroceles in patients who have undergone renal transplantation.

Gastroesophageal reflux after endoscopic injection sclerotherapy.

The effect of sclerotherapy of esophageal varices on the gastroesophageal reflux was studied. Gastroesophageal reflux was monitored by a 24-h pH-monitoring catheter introduced into the distal esophagus. The results of pH monitoring of 16 patients who underwent sclerotherapy were compared with those of 21 patients with untreated varices. Seven of the 16 treated patients showed high occurrence rates of gastroesophageal reflux comparable to those observed in cases with severe reflux esophagitis. In the untreated group, only one patient showed pathological reflux (there was a significant difference between treated and untreated groups; p less than 0.01). When the level of reflux was compared with factors that might influence sclerotherapy-induced gastroesophageal reflux, there was a positive correlation between the magnitude of reflux and amount of sclerosant injected paravariceally in the submucosal tissue (p less than 0.05). The results indicate that the paravariceal injection of sclerosant for the treatment of esophageal varix may cause pathological gastroesophageal reflux after sclerotherapy is completed.

CT after uncomplicated esophageal sclerotherapy.

CT scans of the lower chest were performed before and after elective uncomplicated endoscopic esophageal variceal sclerotherapy in nine patients. CT findings included (1) esophageal wall thickening, (2) low attenuation within the wall giving the esophagus a laminated appearance, (3) a predominantly low attenuation mediastinal effusion that was often masslike, (4) obliteration of mediastinal fat planes, (5) thickening of the diaphragmatic crura, (6) pleural effusions, and (7) subsegmental atelectasis. No mediastinal or pleural gas was seen. Changes were less severe in patients who had received sclerotherapy several times in the past and in those who were given the least amount of sclerosant. An understanding of the CT changes after clinically uncomplicated esophageal sclerotherapy will aid in the interpretation of scans performed on patients with suspected complications.