Sodium Tetradecyl Research Articles

Cervical Lymphangiomas in Children: Non-Surgical Treatment with Focus on Sclerotherapy. Literature Review

Objectives: To discuss the non-surgical strategies for the management of cervical lymphangiomas in children, with particular attention to sclerotherapy. Methods: A literature review of the last fifteen years about sclerotherapy of cervical lymphangiomas in children was performed and the main sclerosing agents were reported, highlighting the nature, the mechanism of action and the rates of success, recurrences and complications related to each and every substance; furthermore, the several steps of the procedure are illustrated. Alternative approaches are also mentioned. Results: 47 articles were collected, mostly dealing with sclerotherapy with OK-432, bleomycin/pingyangmycin and doxycycline; other potential substances include, above all, sodium tetradecyl-sulphate and ethanol. Laser therapy and radio-frequency ablation are valid options in case of mucosal micro-cystic lesions; oral medications (e.g. Sirolimus) and the newest target-therapies are added to local treatments in some Series.

Comparative evaluation of bleomycin and setrol in the management of low flow vascular malformations in the head and neck region

Introduction: Vascular malformations in any location usually have a devastating aesthetic effect in addition to that of being associated with pain and bleeding. Sclerotherapy has been used as an effective therapeutic modality for the management of the vascular malformations. This prospective study was intended to evaluate and compare the efficacy of bleomycin and Setrol in the management of low flow vascular malformations in the head and neck region. Materials and Methodology: The study was carried out among 60 patients within the age group ranging from 8 years – 40 years. All the patients were diagnosed with vascular malformations both clinically as well as by Doppler study. The stipulated period that was adopted for this study was between June 2019 to April 2022. After fulfilling the inclusion criteria, cases were randomly assigned into two groups of sixteen each. Group 1 was administered bleomycin 8 mg, freshly prepared in 2 ml normal saline and 2% lidocaine 2 ml. Group 2 was administered 1 ml of 3% sodium tetra-decyl sulphate and 2 ml of 2% lidocaine. Results: The effectiveness of bleomycin was found to be superior to STS, when used as Intralesional Sclerotherapy agent. Most of the vascular lesions of group 1 resolved after first dose giving a cure rate of 93.75% and only one patient required a second injection of bleomycin to obtain cure, after 3 weeks with no recurrence was observed. Group 2 patients were not cured following first intralesional injection of STS except for the small sized lesions. All the cases required 4-6, a mean of five injections to obtain cure. Ten patients out of 16 reported back with recurrence within 2 years. Six patients in group 2 came under the category of effective, giving an overall effective response rate of 37.5% and the drug was ineffective in of 62.5% cases. Conclusion: Sclerotherapy with direct intralesional injection of bleomycin was found to be superior to STS and found that there was no recurrence rate in bleomycin group when compared to STS group. However, 3% Setrol solution is relatively simple, safe and effective modality for managing head and neck vascular malformations that can be done as an in-office procedure. Smaller lesions have a more favourable response.

S2804 Refractory Bleeding From Nodular Gastric Antral Vascular Ectasia (GAVE): Is Combination Therapy of Sclerotherapy and Band Ligation the Solution?

Introduction: Gastric antral vascular ectasia (GAVE) is a rare condition that presents in the distal stomach as dilated longitudinal columns of blood vessels prone to bleeding. Nodular GAVE is an even rarer variant and is often refractory to standard therapy for GAVE. Endoscopic treatment options widely varies and include rubber band ligation, radiofrequency ablation (RFA), argon plasma coagulation (APC), and resection with hot snare. We present a case study of successful treatment of nodular GAVE of a patient who has been refractory to repeated APC with combination therapy of band ligation and sclerotherapy. Case Description/Methods: 63-year-old female with history of alcoholic cirrhosis and pancreatitis who has had persistent iron deficiency anemia thought secondary to chronic blood loss requiring constant transfusions. Initial EGD was performed at age of 60 with evidence of small grade I esophageal varices, portal hypertensive gastropathy, and innumerable gastric polyps in the gastric body and antrum that on biopsy was consistent with nodular GAVE. She then underwent 5 repeat EGDs over a span of 6 months with a combination RFA, APC, snare resection followed by hemostatic clipping, and banding, with continued recurrence of nodular GAVE and transfusion dependent anemia, with total of 17 units of packed red blood cell (pRBC) transfusions required over the same 6 month period. On her seventh EGD, she then underwent combination therapy of sclerotherapy (1% sodium tetradecyl sulfate (STS), 20mL total), which were injected at the base of the nodular areas, along with placement of 12 bands. Her transfusion requirements subsequently subsided after the initial sclerotherapy and band ligation combination session, and the patient received additional 6 EGD sessions with repeat combination therapy over the next 12 months, with notable visual improvement endoscopically subsequent to 2 sclerotherapy plus banding sessions. She only required a total of 3 units of pRBC transfusion over the same period. (Figure) Discussion: We described the first known case of combination sclerotherapy and band ligation therapy for treatment of refractory nodular GAVE. The treatment resulted in significant reduction in transfusion requirements with concomitant improvement of the appearance of nodular GAVE even after just 2 sessions, and may be particularly useful in patients who have failed more conventional treatments. Additional studies will need to be performed to determine the safety and efficacy of this combination treatment modality.Figure 1.: endoscopic images of nodular GAVE before and after serial treatments, along with a timeline of hemoglobin level, transfusions, and endoscopic sessions/therapies over the patient's follow up period of 1.5 years.

The Efficacy of 3% Sodium Tetradecyl Sulphate (STS) Injection in Management of Intraoral Soft Tissue Vascular Lesion

Aim: To evaluate the efficacy of 3% sodium tetradecyl sulphate (STS) in intraoral vascular lesions. Methods: Cross sectional study was done in oral and maxillofacial surgery department of Islam dental college from 1st Jan 2020 to 31st Dec 2021. 18 cases were selected with non-probability sampling technique.3% STS solution was intralesional injected. Site and size of lesion, pain intensity, burning sensation, tissue necrosis and area numbness variables were observed on preoperative,1stpostop, and then every 14th day until lesion subside and findings were documented in Performa. Results: Results were analysed statistically with SPSS version 23. Female 14 cases had predominance with 4 male cases. Mostly common site of lesion was tongue with 7 cases, 4 cases in cheek and 4 cases had involvement of lip area, 3 cases had lesion in the floor of mouth. 11 cases had mild pain, moderate pain in 5 cases and 2 cases with severe pain. 14 cases had burning sensation and 7 cases had tissue necrosis with area numbness. Conclusion: 3% Sodium tetradecylsulphate sclerosing agent usage is safe, cost effective and efficient to manage intraoral soft tissue vascular lesion. Although further studies are needed on large sampling data with longer follow-up. Keywords: Sodium tetradecyl sulphate, vascular lesion, haemangioma, sclerotherapy.

Comparative Evaluation of Efficacy and Safety of the Diode Laser (980 nm) and Sclerotherapy for the Treatment of Oral Pyogenic Granuloma.

Background Pyogenic granuloma (PG) is a tumor-like, non-neoplastic lesion of the soft tissue that commonly appears in the oral cavity. Various treatment modalities have been discussed, including surgical excision, cryosurgery, curettage, electrodessication, corticosteroid injection, sclerotherapy, and lasers. This observational retrospective study compared effectiveness between diode lasers and sclerotherapy for PG treatment. Materials and Methods From July 2016 to January 2021, data of oral PG cases treated with sclerotherapy and diode lasers were gathered. Patients were evaluated and categorized according to their gender, sex, site of lesions, size of lesions, number of sessions, details of side effects, details of the VAS (Visual Analogue Scale) on third postoperative day, response of treatment to individual groups, time required for complete resolution, and details of recurrence. Inferential statistical analysis was performed. Results We included 73 patients, of whom 43 and 30 received laser and sclerotherapy treatment, respectively. Compared with the sclerotherapy group, the laser group had less side effects including pain, edema, ulceration, ecchymosis, infections, and scarring. The difference in postoperative pain (VAS scale) between the groups was statistically significant (p-value 0.004). Complete remission was seen in the laser group, while 3 cases of the sclerotherapy group had no response (p-value −0.034). The laser group experienced greater recurrence than did the sclerotherapy group. Conclusions Both sclerotherapy with laser and 3% sodium tetradecyl sulfate are effective for treating oral PG. Sclerotherapy is more effective in preventing recurrence. In terms of side effects, diode lasers are superior to sclerotherapy.

Factors Affecting Adverse Events after Venous Malformation Sclerotherapy

PurposeTo evaluate factors that contribute to adverse events (AEs) after embolization of venous malformations (VMs) using sclerosing agents. Materials and MethodsA retrospective review of patients who underwent direct puncture embolization of VMs with a sclerosing agent and adjunctive techniques, also termed as sclerotherapy, from 2016 to 2021 was performed. Three-hundred one embolizations in 137 patients (median age, 19.0 years; interquartile range, 12.8–31.5 years) were evaluated. The VM characteristics and embolization details were analyzed. Anticoagulation was also evaluated based on D-dimer levels. Cutaneous and noncutaneous AEs were analyzed. The AEs were categorized using Society of Interventional Radiology guidelines. ResultsVMs involving tissue planes were subcutaneous (n = 104), intramuscular (n = 84), and combined (n = 113). Overlying skin involvement was observed in 56% of the patients. Sodium tetradecyl sulfate was mainly used (83%). Periprocedural anticoagulation was used in 9% of the patients. Most AEs were minor (30/301, 9.7%), and only 1.7% (5/301) were major (21 cutaneous and 14 noncutaneous AEs). Age below 18 years (odds ratio, 4.4502; 95% confidence interval, 1.5607–12.6890; P = .0052) and overlying skin involvement (odds ratio, 7.1794; 95% confidence interval, 1.6226–31.7656; P = .0094) were factors associated with cutaneous AEs. All noncutaneous AEs developed in patients with intramuscular VMs; however, this association was not statistically significant. There was no severe hematologic AE or permanent consequence. ConclusionsThe overall AE rate after VM embolization was 11.6%; however, major AEs were rare (1.7%). Cutaneous AEs were associated with young age and overlying skin involvement. All noncutaneous AEs developed in patients with intramuscular VMs.

Comparative Evaluation of Efficacy and Safety of the Diode Laser (980 nm) and Sclerotherapy in the Treatment of Oral Vascular Malformations.

Background Vascular malformations are structural abnormalities which are formed by progressively enlarging aberrant and ecstatic vessels without endothelial cell proliferation and composed of the type of vessel involved, i.e., capillary, veins, and arteriovenous. Treatment of vascular malformations may involve many techniques like sclerotherapy, embolization, surgical resection, cryotherapy, laser treatment, or medical therapy. This observational prospective study is aimed at evaluating and comparing the effects and efficacy of diode laser and sclerotherapy in the treatment of oral vascular malformation. Materials and Methods 40 patients presenting with oral vascular malformation were included in the present study. The patients were divided equally (20 in each) into two groups, i.e., the laser group and sclerotherapy group. Sclerotherapy was performed with 3% sodium tetradecyl sulfate while the laser group was treated with diode laser 980 nm with transmucosal thermophotocoagulation. The patients were assessed for the response, remission, and side effects. The results obtained were tabulated and compared with the chi-square test. Results Side effects were found significantly lesser in the laser group compared to the sclerotherapy group (p < 0.05). Statistically significant difference was seen for postoperative pain between two groups. The laser group had mild to moderate pain compared to severe pain in the sclerotherapy group. Recurrence was observed more in the laser group compared to the sclerotherapy group. Conclusions Laser and sclerotherapy with 3% sodium tetradecyl sulfate both are effective in the treatment of vascular malformations. Diode laser seems to be better than sclerotherapy given lesser side effects and comfort to the patients while sclerotherapy seems to be better in respect to recurrences.

Combined sclerotherapy followed by surgical resection of a large extracranial venous malformation in a 14-month-old child: preoperative workup and technical note

IntroductionVenous malformations affect around 2 per 10,000 newborn and are the most common type of congenital vascular malformation. They are always present at birth and are often misdiagnosed with hemangiomas. Accurate diagnosis and adequate targeted therapy through a multidisciplinary approach is advocated for a successful treatment, considering a combination of modalities in complex cases. We present here the workup and treatment of a venous malformation in a 14 month old child by combining a preoperative sclerotherapy with sodium tetradecyl sulfate (STS) followed by complete surgical excision respecting the calvarium.Case presentation.A large right extracranial fronto-parietal venous malformation and scalloping of the underlying calvarium, attached to the pericranium, surgically excised after preoperative sclerotherapy with STS in a 14-month-old child.ResultsThe patient had an uneventful postoperative course with complete resection of the lesion, satisfying cosmetic appearance and no complications. Histopathological examination confirmed a venous malformation.ConclusionWe demonstrated the workup and the rationale of the combined sclerotherapy followed by surgical resection of a large growing extracranial venous malformation. Preoperative direct contrast injection and sclerotherapy allowed to rule out significative extracranial to intracranial venous inflow and reduce blood loss for the surgical procedure, respectively. Complete removal of the malformation minimized the impact on future growth of the calvarium.

Luminescent probe synthesis for oxygen visualization technique: Application to the effect of surfactant structure on oxygen mass transfer

Planar Laser Induced Fluorescence with Inhibition (PLIF-I) is a powerful technique for studying the local gas/liquid oxygen mass transfer from a single rising bubble. However, to track oxygen in the liquid phase, it is necessary to use an oxygen sensitive luminescent probe, which needs to be unreactive toward the liquid phase. This article presents the synthesis of a fluorophore, [Ru(dpp-diSO3)3]Na4, to be used in liquid phases containing anionic molecules. To avoid electrostatic interactions, the fluorophore and the component present in the liquid phase need to have the same charge. Thanks to the use of this new luminescent probe in PLIF-I application, the influence of the chain length of anionic surfactants (dodecyl sulfate sodium salt and tetradecyl sulfate sodium salt) on oxygen mass transfer has been studied at different concentrations (1.3 × 10-3-2.5 × 10-7 mol.L-1). Results show that, for a given bulk concentration, the longer the hydrophobic chain, the greater the decrease in velocity and mass transfer coefficient. These results are compared with those of a previous paper dealing with length of cationic and nonionic surfactants and a correlation is proposed, taking account of the intrinsic properties of surfactants and their concentration in the liquid phase.

Elimination of light chain tailing in reducing capillary electrophoresis with sodium dodecyl sulfate analysis of a monoclonal antibody.

Capillary electrophoresis with sodium dodecyl sulfate (CE-SDS) is a common analytical technique for investigating the purity and molecular size heterogeneity of monoclonal antibody (mAb) drugs. In reducing CE-SDS analysis of mAb-A, the light chain (LC) peak exhibited severe tailing, seriously affecting the purity analysis. The purposes of this investigation are to clarify the source of tailing and develop a more appropriate CE-SDS method to eliminate LC tailing. The degree of LC tailing was closely related to the mAb concentration, SDS concentration, and injection amount, and more hydrophobic detergents, such as sodium hexadecyl sulfate (SHS) and sodium tetradecyl sulfate (STS), could be used instead of SDS to obtain better peak shapes. The results also indicated that the tailing was caused by the binding problem associated with SDS, and SHS/STS could provide a more stable and uniform complexation for the LC. In summary, the method we developed successfully eliminated the LC tailing and provided a robust characterization of mAb-A in reducing CE-SDS analysis.

Investigation of an Uncommon Artifact during Reducing Capillary Electrophoresis-Sodium Dodecyl Sulfate Analysis of a Monoclonal Antibody with Dynamic Light Scattering and Reversed Phase High-Performance Liquid Chromatography.

In reducing capillary electrophoresis sodium dodecyl sulfate (CE-SDS) analysis of a monoclonal antibody (mAb-1), the peak area ratio of heavy chain (HC) to light chain (LC) was out of balance, while multiple artifact peaks were observed following the migration of HC. The main purposes of this study were to describe the techniques utilized to eliminate this artifact and clarify the root cause for this interesting phenomenon. We optimized the CE-SDS analysis of mAb-1 by a vairety of techniques including changing the concentration of protein or replacing SDS with a more hydrophobic surfactant (i.e., sodium hexadecyl sulfate (SHS) or sodium tetradecyl sulfate (STS) instead of SDS) in sample and/or the sieving gel buffer. Dynamic light scattering (DLS) and reversed phase high-performance liquid chromatography (RP-HPLC) were used to study the protein-surfactant complex. The artifact could be partially mitigated by reducing the protein concentration and replacing SDS with SHS or STS in the sample and/or the sieving gel buffer solutions. Due to replacing a more hydrophobic surfactant, the HC-surfactant complex formed was more resistant to dissociation, preventing additional hydrophobic HC-HC interaction and aggregation, thus eliminating the artifact problem. DLS and RP-HPLC are powerful supplementary techniques in characterizing the protein-surfactant complex, and hydrophobic surfactants such as SHS and STS could afford more normal electropherograms during the analysis of mAbs.

Safety of High-Dose 3% Sodium Tetradecyl Sulfate for Sclerotherapy of Renal Cysts in Patients with Autosomal Dominant Polycystic Kidney Disease

This study assessed the safety profile of high-volume (>10 mL) 3% sodium tetradecyl sulfate (STS) sclerotherapy for the treatment of renal cysts in patients with autosomal dominant polycystic kidney disease. A total of 211 sclerotherapy treatments were performed in 169 patients over a 5-year period, with a comparison of 2 patient cohorts based on the STS volumes used. The first cohort (n = 112) received a high volume (greater than 10 mL) of STS, and the second cohort (n = 57) received a low volume (less than 10 mL). The minor adverse event rate for the cohorts was 14.5% and 9.6%, respectively (P = .310), with postprocedure pain being the most common event. One major adverse event occurred, for which the patient required hospitalization for infection after low-volume STS treatment. Doses of STS higher than those currently recommended by the Food and Drug Administration for intravascular use allow large renal cysts to be treated safely in the setting of autosomal dominant polycystic kidney disease.

Abstract No. 213 Portal vein embolization using sodium tetradecyl sulfate foam sclerosant versus microsphere particle embolization: a retrospective comparative analysis

Portal vein embolization (PVE) is performed to induce future liver remnant (FLR) hypertrophy prior to resection. A variety of embolic materials have been used for PVE, though the agent to induce maximal hypertrophy remains undetermined. 3% sodium tetradecyl sulfate (STS) is foamed with ethiodized oil and air prior to injection behind balloon occlusion of the proximal right portal vein, allowing impregnation of the portal venules and sinusoids. Microsphere particle (MSP) embolization relies on flow-directed therapy to deliver particles to the terminal portal veins and is followed by particles of escalating size and concluded with coil or plug embolization of the right portal vein.

Analysis of adverse events with sclerosants reported to the United States Food and Drug Administration.

To analyze adverse events (AEs) related to sclerosants reported through the Federal Adverse Event Reporting System (FAERS). We queried the FAERS database for all cases associated with sclerosants. Reports were analyzed and stratified based on severity of cases and patient death. A total of 1215 cases with 3124 reactions were identified among 4 sclerosants. "General disorder and administration site conditions" reaction group was prevalent in all sclerosants. For polidocanol, deep vein thrombosis and pulmonary embolism were the most common severe reactions while cardiac arrest was frequent in death cases. Anaphylaxis was common in fatalities of sodium tetradecyl sulfate. Ethanolamine oleate was associated with procedural errors, while morrhuate sodium resulted in few cases. Our analysis supports previous studies concerning common local symptoms, but also reveals serious and death associated reaction profiles specific to individual sclerosants. Practitioners should be knowledgeable on both non-lethal and fatal AEs for each sclerosant. The multitude of reports concerning serious reactions and deaths we report herein provide a cautionary reminder to venous practitioners and patients that sclerotherapy is not a trivial procedure.

Strain Ultrasound Elastography of Aneurysm Sac Content after Randomized Endoleak Embolization with Sclerosing vs. Non-sclerosing Chitosan-based Hydrogels in a Canine Model

PurposeTo compare the mechanical properties of aneurysm content after endoleak embolization with a chitosan hydrogel (CH) with that with a chitosan hydrogel with sodium tetradecyl sulfate (CH-STS) using strain ultrasound elastography (SUE). Materials and MethodsBilateral common iliac artery type Ia endoleaks were created in 9 dogs. Per animal, 1 endoleak was randomized to blinded embolization with CH, and the other, with CH-STS. Brightness-mode ultrasound, Doppler ultrasound, SUE radiofrequency ultrasound, and computed tomography were performed for up to 6 months until sacrifice. Radiologic and histopathologic studies were coregistered to identify 3 regions of interest: the embolic agent, intraluminal thrombus (ILT), and aneurysm sac. SUE segmentations were performed by 2 blinded independent observers. The maximum axial strain (MAS) was the primary outcome. Statistical analysis was performed using the Fisher exact test, multivariable linear mixed-effects models, and intraclass correlation coefficients (ICCs). ResultsResidual endoleaks were identified in 7 of 9 (78%) and 4 of 9 (44%) aneurysms embolized with CH and CH-STS, respectively (P = .3348). CH-STS had a 66% lower MAS (P < .001) than CH. The ILT had a 37% lower MAS (P = .01) than CH and a 77% greater MAS (P = .079) than CH-STS. There was no significant difference in ILT between treatments. The aneurysm sacs embolized with CH-STS had a 29% lower MAS (P < .001) than those embolized with CH. Residual endoleak was associated with a 53% greater MAS (P < .001). The ICC for MAS was 0.807 (95% confidence interval: 0.754–0.849) between segmentations. ConclusionsCH-STS confers stiffer intraluminal properties to embolized aneurysms. Persistent endoleaks are associated with increased sac strain, an observation that may help guide management.

Sodium Tetradecyl Sulphate Sclerotherapy for Lateral Malleolar Bursitis of the Ankle.

BackgroundThe aim of this study was to evaluate clinical outcomes of sodium tetradecyl sulphate (STS) sclerotherapy for conservative treatment of lateral malleolar bursitis of the ankle.MethodsWe reviewed data from 20 consecutive patients (20 ankles) who underwent STS sclerotherapy between August 2018 and June 2019. After aspiration of fluid from the lateral malleolar bursal sac, 2 mL (20 mg) STS was injected into the sac. Clinical outcomes and side effects and complications were evaluated at 2 weeks, 3 months, 1 year, and 2 years after sclerotherapy. Responses to treatment were assessed according to degree of fluctuation, shrinkage of the bursal sac, and soft-tissue swelling. The 36-item short form survey (SF-36) was completed for each patient before and after therapy.ResultsComplete response was observed in 17 patients (85%), and partial response was observed in 3 patients (15%) after STS sclerotherapy. SF-36 physical component scores improved from 62.2 (interquartile range, 5.2) before therapy to 70.0 (interquartile range, 7.9) at last follow-up (p < 0.05). One patient (5%) experienced transient hyperpigmentation at the injection site. No major complications occurred.ConclusionsSTS sclerotherapy was an effective and safe treatment for patients with lateral malleolar bursitis of the ankle.

Treatment of Recurrent Symptomatic Saphenous Trunk Reflux with Catheter Directed Foam Sclerotherapy and Tumescent Anaesthesia

ObjectiveThe aim was to assess short and midterm efficacy and safety of catheter directed foam sclerotherapy (CDFS) with tumescent anaesthesia in patients with recurrent symptomatic saphenous reflux.MethodsThis was a prospective observational study (February 2018 to February 2019) including 21 consecutive patients referred with recurrent symptomatic varicose veins. Standing duplex ultrasound (DUS) with saphenous vein diameter measurement 3 cm from the terminal valve was performed pre-operatively. All the patients were operated on under local anaesthesia. By ultrasound guided puncture a hydrophilic 0.035″ guidewire and 5F Berenstein catheter were inserted through a 5F introducer sheath. Peri-saphenous tumescent anaesthesia (PSTA) was performed under ultrasound guidance. Sclerosant foam was prepared with sodium tetradecyl sulphate 3% or polidocanol 3% using the Tessari method. Concomitant phlebectomies were performed in 52%. Clinical evaluation and DUS were performed pre- and post-operatively at one week, six months, and 12 months.ResultsThere were 11 men and 10 women (median age 52 years; interquartile range [IQR] 43 – 61). The great saphenous vein was treated in 18 patients. The median vein diameter was 6.8 mm (IQR 4.7 – 8.9). Previous procedures were Cure conservatrice et Hemodynamique de l'Insuffisance Veineuse en Ambulatoire (CHIVA), mechanochemical ablation, thermal ablation, and cyanoacrylate closure. The distribution of the clinical class (Clinical Etiology Anatomy Pathophysiology [CEAP] classification) was 16 C2, three C3, and two C4 limbs. Immediate technical success was 100%. There were no complications in the early post-operative period. The median follow up was eight months (IQR 5 – 10). The occlusion rate demonstrated by DUS was 100% (21/21) at one week, 100% (21/21) at six months, and 86% (18/21) at 12 months. The median post-procedural vein diameter at one week, six months, and 12 months was 4.8 mm (IQR 3.9 – 6), 4.3 mm (IQR 3.5 – 5.5), and 4 mm (IQR 3 – 4.9), respectively.ConclusionCombination CDFS with PSTA achieves good short and medium term venous occlusion rates, associated with few complications in patients with recurrent symptomatic saphenous reflux.

Injection sclerotherapy for varicose veins.

Injection sclerotherapy for varicose veins.

Photophysics of a cyanine dye in the protein-surfactant aggregates

In this work we have studied the photophysical properties of a cyanine dye merocyanine 540 (MC540) in the presence as well as in the absence of bovine serum albumin (BSA) along with anionic surfactants sodium dodecyl sulfate(SDS) and sodium tetradecyl sulfate (STDS) and cationic surfactants cetrimonium bromide (CTAB) and dodecyltrimethylammonium bromide (DTAB) with the help of various spectroscopic methods. MC540 in protein-surfactant aggregates as well as surfactant aggregates interacts differently with anionic and cationic surfactants. MC540 exits in both monomer and dimer form in the buffer medium however, in protein-surfactant aggregates and surfactant aggregates monomer–dimer equilibrium is perturbed, where only the monomer form exists. By employing various spectroscopic methods it is evident that in the presence of cationic and anionic surfactants, MC540 strongly interacts with cationic micelles compared to anionic micelles. MC540 being a negatively charged molecule in the buffer medium, electrostatic repulsion is predominant with anionic surfactants whereas, electrostatic attraction is predominant with cationic surfactants in protein-surfactant aggregates as well as in micelles.

Microfoam sclerotherapy of superficial venous malformations of the upper limbs

Venous malformations are the most common type of angiodysplasia, which cause both physiological and emotional discomfort to patients. Arteriovenous malformations occur most often in the upper and lower limbs at the ratio of 20.9% and 46.4%, respectively. On top of that, 70% of cases of superficial arteriovenous malformations are found in women. In this article, the authors present a clinical example of the effectiveness of microfoam sclerotherapy and show a long-term outcome in a patient with superficial venous malformations of her hands, which are accompanied with such symptoms as as pain and bleeding. As a sclerosing agent, a 1–3% sodium tetradecyl sulphate solution was used, followed by compression using class 2 garments (RAL standard) such as an arm sleeve and gloves. The interval between procedures was 4 to 6 weeks. After several sessions, the superficial venous malformations of the upper limb decreased in the size and volume, and the patient presented less complaints. A 5-year follow-up showed no growth of malformations and re-bleeding complications. Microfoam sclerotherapy of superficial venous malformations in the upper limbs (hands) has good long-term outcomes and allows patients to avoid traumatic surgery. Given this comparability of the surgical and minimally invasive techniques, the use of the latter option, in particular, the foam sclerotherapy technique, makes economic and financial sense.