ABSTRACT
Plantar warts are common skin lesions that continue to represent a therapeutic challenge. They are still resistant to therapy and are highly recurrent, despite the diverse number of treatments available. Therapies targeting vasculature, such as pulsed dye laser, have been used successfully in the treatment of plantar warts. Polidocanol, a detergent sclerosant approved for the sclerotherapy of incompetent and dilated saphenous veins, has also been used as an off-label therapy for a wide range of skin conditions with vascular components such as hemangiomas and pyogenic granuloma. The current, open-label, prospective, pilot study aimed to evaluate the safety and efficacy of the intralesional polidocanol 3% in the treatment of plantar warts. Twenty patients (11 females and 9 males), with plantar warts, aged 12-50 years received biweekly sessions of intralesional polidocanol 3% until complete clearance or for a maximum of 6 sessions. Response to treatment was graded as complete (100% clearance), partial (50-99%), and no response (< 50%). At the end of the study, 12 (60%) patients achieved complete clearance of their warts after 1-5 sessions, 5 (25%) patients had only partial response, and 3 (15%) patients did not achieve any clearance of their warts. The procedure was largely tolerable by patients. Pain at the injection site and bruises were reported by 9 (45%) and 2 (10%) patients, respectively. Both side effects resolved spontaneously and completely within a few days. The findings of the current study suggest that intralesional injection of 3% polidocanol in biweekly sessions may be a safe, effective, and tolerable method for the treatment of plantar warts.
Subject(s)
Injections, Intralesional , Polidocanol , Sclerosing Solutions , Sclerotherapy , Warts , Humans , Polidocanol/administration & dosage , Pilot Projects , Female , Male , Adult , Sclerotherapy/methods , Sclerotherapy/adverse effects , Warts/therapy , Warts/drug therapy , Adolescent , Middle Aged , Treatment Outcome , Young Adult , Sclerosing Solutions/administration & dosage , Sclerosing Solutions/adverse effects , Prospective Studies , ChildABSTRACT
BACKGROUND: Hemorrhage associated with varices at the site of choledochojejunostomy is an unusual, difficult to treat, and often fatal manifestation of portal hypertension. So far, no treatment guidelines have been established. CASE SUMMARY: We reported three patients with jejunal varices at the site of choledochojejunostomy managed by endoscopic sclerotherapy with lauromacrogol/α-butyl cyanoacrylate injection at our institution between June 2021 and August 2023. We reviewed all patient records, clinical presentation, endoscopic findings and treatment, outcomes and follow-up. Three patients who underwent pancreaticoduodenectomy with a Whipple anastomosis were examined using conventional upper gastrointestinal endoscopy for suspected hemorrhage from the afferent jejunal loop. Varices with stigmata of recent hemorrhage or active hemorrhage were observed around the choledochojejunostomy site in all three patients. Endoscopic injection of lauromacrogol/α-butyl cyanoacrylate was carried out at jejunal varices for all three patients. The bleeding ceased and patency was observed for 26 and 2 months in two patients. In one patient with multiorgan failure and internal environment disturbance, rebleeding occurred 1 month after endoscopic sclerotherapy, and despite a second endoscopic sclerotherapy, repeated episodes of bleeding and multiorgan failure resulted in eventual death. CONCLUSION: We conclude that endoscopic sclerotherapy with lauromacrogol/α-butyl cyanoacrylate injection can be an easy, effective, safe and low-cost treatment option for jejunal varicose bleeding at the site of choledochojejunostomy.
Subject(s)
Choledochostomy , Gastrointestinal Hemorrhage , Jejunum , Sclerotherapy , Varicose Veins , Humans , Male , Varicose Veins/therapy , Varicose Veins/surgery , Choledochostomy/methods , Choledochostomy/adverse effects , Sclerotherapy/methods , Sclerotherapy/adverse effects , Gastrointestinal Hemorrhage/etiology , Gastrointestinal Hemorrhage/therapy , Gastrointestinal Hemorrhage/diagnosis , Jejunum/surgery , Jejunum/blood supply , Middle Aged , Treatment Outcome , Female , Aged , Enbucrilate/administration & dosage , Enbucrilate/adverse effects , Hypertension, Portal/surgery , Hypertension, Portal/complications , Hypertension, Portal/diagnosis , Sclerosing Solutions/administration & dosage , Sclerosing Solutions/adverse effects , Polidocanol/administration & dosage , Polidocanol/therapeutic use , Pancreaticoduodenectomy/adverse effects , Pancreaticoduodenectomy/methods , Endoscopy, Gastrointestinal/methodsABSTRACT
BACKGROUND AND OBJECTIVE: Lower limb varicose veins are a prevalent disease associated with several available treatment options, including conventional surgery and polidocanol foam sclerotherapy. However, few studies have analyzed therapeutic modality outcomes based on Patient-Reported Outcome Measures (PROMs). This large sample-size study was designed to evaluate the outcomes of polidocanol foam sclerotherapy compared to conventional surgery based on an analysis of PROMs. METHODS: This was a prospective, observational, and qualitative study of 205 patients who underwent varicose vein treatment with either polidocanol foam sclerotherapy (57 patients, 90 legs) or conventional surgery (148 patients, 236 legs). Patients were preoperatively assessed and re-evaluated 30 days after the procedure using the Venous Disease Severity Score (VCSS) and specific venous disease quality-of-life questionnaires (VEINES-QoL/Sym). RESULTS: Both treatments significantly improved VCSS and VEINES results 30 days after the procedure (p < 0.05). However, surgery promoted greater improvements in VCSS (on average 4.02-points improvement, p < 0.001), VEINES-QoL (average 8-points improvement, p < 0.001), and VEINES-Sym (average 11.66 points improvement, p < 0.001) than did sclerotherapy. Postoperative pain and aesthetic concerns about the legs were the domains of the questionnaires in which the results varied the most between the treatment modalities, with worse results for sclerotherapy. CONCLUSION: Both polidocanol foam sclerotherapy and conventional surgery positively impact patients' quality of life after 30 days, but the improvement is more significant for patients who undergo conventional surgery.
Subject(s)
Quality of Life , Varicose Veins , Humans , Polidocanol , Polyethylene Glycols , Prospective Studies , Saphenous Vein , Sclerosing Solutions/therapeutic use , Sclerosing Solutions/adverse effects , Sclerotherapy/adverse effects , Treatment Outcome , Varicose Veins/surgery , Varicose Veins/therapyABSTRACT
BACKGROUND: Polidocanol endovenous microfoam (PEM) has been used to treat lower extremity venous reflux for almost one decade with specific advantages for below knee (BK) truncal veins where thermal ablation poses a risk of injury to adjacent nerves. The current literature of the BK segment often examines short-term outcomes with modest sample sizes. We aim to identify factors associated with recanalization and reintervention in this subset of patients. METHODS: We performed a retrospective study of a prospectively maintained database of patients from a single institution who underwent 1% PEM ablation for BK great saphenous vein (GSV) and small saphenous vein (SSV) reflux. Patients underwent duplex ultrasound (DU) within 7 days after injection, every 3 to 6 months for 1 year, and every 6 to 12 months thereafter. Patients with symptomatic recanalization underwent reintervention. The 26 patients lost to follow-up without DU after ablation were excluded. The factors associated with recanalization and reintervention were examined by multivariate and nonparametric analyses. RESULTS: Between March 2018 and July 2023, 411 patients (166 male, 245 female) with 573 treated limbs (284 right, 289 left) met the study criteria. Of the 573 included limbs, 457 (79.8%) had undergone prior above knee saphenous ablations. A total of 554 BK GSV and 42 SSV ablations were performed. The most recent DU was performed at a mean of 231 ± 329 days. The overall recanalization rate was 10.6% (55 GSVs and 8 SSVs) at a mean follow-up of 104 ± 180 days. Comparing the closed and recanalized veins, we found no significant difference in age (P = .90), treated laterality (P = .14), patient body mass index (P = .59), preprocedural CEAP (clinical-etiology-anatomy-pathophysiology) score (P = .79), recanalization rate in GSVs vs SSVs (P = .06), or administered PEM volume (P = .24). The recanalized veins had significantly larger preprocedural diameters than the veins that remained closed (recanalized, 4.9 mm; closed, 4.3 mm; P = .001). Men had higher incidence of recanalization than women (men, 14.2%; women, 8%; P = .015). Anticoagulation use was associated with recanalization (odds ratio, 1.96; 95% confidence interval, 1.1-3.6; P = .03). Early recanalization at the first DU accounted for 31 failures (49.2%) and had a significantly lower administered PEM volume compared with later recanalization (early, 4 mL; late, 5 mL; P = .025). There were no significant differences between the 33 recanalized patients requiring reintervention (52.4%) and the 30 who did not. Twenty-four reinterventions were performed with PEM, 100% of which remained closed at a median of 160 days (interquartile range, 257 days). CONCLUSIONS: PEM is successful for the treatment of BK GSV and SSV reflux with a closure rate of 89% at a mean of 231 days and shows promise as salvage therapy. Most cases of recanalization were noted in the early postprocedure period and were associated with a lower PEM volume. A larger vein diameter, male sex, and anticoagulation use are associated with higher rates of recanalization.
Subject(s)
Polidocanol , Saphenous Vein , Sclerosing Solutions , Venous Insufficiency , Humans , Male , Female , Polidocanol/administration & dosage , Retrospective Studies , Saphenous Vein/surgery , Saphenous Vein/diagnostic imaging , Middle Aged , Venous Insufficiency/diagnostic imaging , Venous Insufficiency/surgery , Venous Insufficiency/therapy , Treatment Outcome , Adult , Sclerosing Solutions/administration & dosage , Sclerosing Solutions/adverse effects , Aged , Time Factors , Risk Factors , Databases, Factual , Sclerotherapy/adverse effects , Endovascular Procedures/adverse effects , Endovascular Procedures/instrumentation , Varicose Veins/diagnostic imaging , Varicose Veins/surgery , Varicose Veins/therapy , Ultrasonography, Doppler, Duplex , RecurrenceABSTRACT
OBJECTIVE: Telangiectasias, characterized by dilated venules, are frequently observed in the lower extremities. Sclerotherapy stands out as the predominant treatment of these vascular lesions. The integration of laser therapy with a mild sclerosing agent, serving as an osmotic sclerosant, presents an enhanced cosmetic treatment approach, aiming to optimize outcomes and minimize potential adverse effects. This study sought to evaluate the feasibility, efficacy, and safety of cryo-laser and cryo-sclerotherapy (CLaCS) and compare it with injection sclerotherapy for the treatment of telangiectasia and reticular veins. METHODS: In this randomized controlled trial, individuals expressing concerns about telangiectasia and reticular veins were recruited for aesthetic treatment. The enrolled patients were prospectively randomized according to the chosen treatment technique. Group A included patients undergoing CLaCS with 70% dextrose, focusing on a single area measuring 20 cm by 20 cm. Group B included patients receiving polidocanol injection sclerotherapy for a single area of the same dimensions. RESULTS: Group A comprised 195 patients and group B comprised 197 patients. The rates of complete lesion elimination after the first, second, and third treatment sessions were 64.6%, 86.2%, and 100% in group A and 50.3%, 74.1%, and 85.3% in group B, respectively. Group A exhibited a significantly higher complete elimination rate compared with group B at the conclusion of the study (P < .001). Furthermore, group A demonstrated a statistically significant lower incidence of postprocedural pigmentation and other complications compared with group B (P < .001). These findings underscore the enhanced efficacy and safety profile associated with the CLaCS technique using 70% dextrose compared with injection sclerotherapy with polidocanol. CONCLUSIONS: CLaCS, combining cryo-laser and cryo-sclerotherapy, demonstrated superior efficacy and safety compared with traditional polidocanol sclerotherapy for treating telangiectasia and reticular veins.
Subject(s)
Polidocanol , Sclerosing Solutions , Sclerotherapy , Telangiectasis , Humans , Telangiectasis/therapy , Sclerotherapy/adverse effects , Sclerotherapy/methods , Female , Male , Sclerosing Solutions/administration & dosage , Sclerosing Solutions/adverse effects , Adult , Polidocanol/administration & dosage , Polidocanol/therapeutic use , Middle Aged , Treatment Outcome , Prospective Studies , Cryosurgery/adverse effects , Polyethylene Glycols/administration & dosage , Glucose/administration & dosage , Veins/diagnostic imaging , Feasibility Studies , Laser Therapy/adverse effects , Young Adult , Aged , Time FactorsSubject(s)
Sclerosing Solutions , Sclerotherapy , Telangiectasis , Humans , Telangiectasis/therapy , Sclerotherapy/adverse effects , Sclerotherapy/methods , Fluoroscopy , Sclerosing Solutions/adverse effects , Sclerosing Solutions/administration & dosage , Female , Hand/blood supply , Middle Aged , MaleABSTRACT
BACKGROUND: Injection sclerotherapy administration is known to cause a decreased recurrence of varicose vein disease. This research aimed to investigate the recurrence of varicose vein disease after giving booster doses of injection sclerotherapy. The booster doses were given at 3rd and 6th months. METHODS: One hundred and fifty patients participated and all patient's included ages 30-70 in the category of 'low risk' patients. The patients were both males and females. Patients participating in the study were counselled appropriately and written consent was taken from them. Moreover, the patients selected were volunteers and agreed to be part of the study. Patients who were above 70 years of age, those who were at a high-risk due to some co-morbidities (high-risk patients), patients not willing to be part of the study, those allergic to drugs being used including sclerosant and people with any known psychiatric illness or cardiac arrhythmias, deep venous thrombosis patients, patients having arteriovenous malformation/venous ulcers were all excluded. If the patient was pregnant, the gynaecology team was taken on board and the procedure was carried out. Every procedure was carried out under the direct supervision of the supervisor. Booster dose sessions of Foam Sclerotherapy were held at 3rd and 6th months of the study time. Their effectiveness was observed and documentation was carried out. RESULTS: Since it was a procedure that could be done in the OPD, there was no need for specialized anaesthesia care. It is of significant notice that when a patient of varicose veins was given a booster intravenous sclerosant injection at 3rd and 6th month of treatment, chances of recurrence decreased to 50%.
Subject(s)
Sclerotherapy , Varicose Veins , Male , Female , Humans , Sclerotherapy/methods , Sclerosing Solutions/adverse effects , Follow-Up Studies , Retrospective Studies , Varicose Veins/therapy , Injections, Intravenous , Treatment Outcome , Saphenous VeinABSTRACT
Foam stability affects the efficacy and incidence of side effects of foam sclerotherapy. Exploring the relationship between foam pressure difference and foam stability can provide ideas and basis for obtaining more stable foam. In the experiment, sodium cod liver oleate foam was selected, and poloxamer 188 (concentration of 0%, 4%, 8%, 12%) was added to realize the change of foam pressure. By using the self-written program to process the foam pictures, the foam pressure difference and the relationship between the foam stability indicators (water separation rate curve, half-life) and the foam pressure difference were obtained. The results showed that at first the foam pressure increased with the increase of the concentration, and then it decreased with the increase of the concentration and reached a peak at the concentration of 4%. The foam pressure difference decreases continuously with the increase of decay time. When the additive concentration is low, the foam average pressure difference increases. And if the additive concentration is too high, the foam average pressure difference decreases. The smaller the foam pressure difference is, the better the foam stability is. This paper lays a foundation for the research on the stability of foam hardener.
Subject(s)
Humans , Half-Life , Poloxamer , Sclerosing Solutions/adverse effects , Sclerotherapy , Varicose VeinsSubject(s)
Humans , Male , Aged , Esophageal and Gastric Varices/therapy , Sclerotherapy/methods , Endoscopy, Digestive System/methods , Polyethylene Glycols/therapeutic use , Pulmonary Embolism/etiology , Sclerosing Solutions/adverse effects , Sclerosing Solutions/therapeutic use , Chest Pain/etiology , Esophageal and Gastric Varices/diagnosis , Esophageal and Gastric Varices/etiology , Tomography, X-Ray Computed , Sclerotherapy/adverse effects , Ethiodized Oil , Cyanoacrylates/administration & dosage , Dyspnea/etiologyABSTRACT
Insuficiencia venosa es definida como la patología que causa síntomas en los miembros inferiores, incluyendo edema, hiperpigmentación, lipodermatoesclerosis y ulceración e implica una anormalidad funcional del sistema venoso. Objetivo: Se compararon los resultados en cuanto a complicaciones y satisfacción reportada por las pacientes, con la Escleroterapia con Polidocanol utilizando aire y agua como diluyente. Métodos: Se incluyeron en el estudio a 60 pacientes del sexo femenino con diagnóstico de Insuficiencia Venosa Superficial CEAP C1, divididas en dos grupos, a las cuales se les aplicó Escleroterapia con Polidocanol mezclado con agua y aire. Se realizó seguimiento durante cuatro semanas donde se recogió la información del paciente con respecto a la mejoría de los síntomas antes de iniciar el tratamiento y los efectos adversos del Polidocanol con ambas terapias. Resultados: Dentro de las complicaciones de ambos tratamientos únicamente fue reportado el Matting en rango leve durante la primera semana. El único síntoma reportado como severo fue Dolor en la escleroterapia con polidocanol mezclado con aire. Los demás signos síntomas fueron reportados dentro del rango de moderado el cual descendió hasta leve entre la segunda y tercera semana, no encontrando reportes a la cuarta semana. La única complicación reportada fue el Matting en la escleroterapia con polidocanol mezclado con aire. Conclusión: No se encontraron diferencias significativas en grado de satisfacción con la eficacia del tratamiento, los efectos adversos, la forma en que se administra el medicamento entre ambos tratamientos de escleroterapia, oscilando los rangos de satisfacción entre el 43 al 70%. (AU)
Venous insufficiency is defined as the pathology that causes symptoms in the lower limbs, including edema, hyperpigmentation, lipodermatosclerosis and ulceration and implies a functional abnormality of the venous system. Objective: The results in terms of complications and satisfaction reported by the patients were compared with Sclerotherapy with Polidocanol using air and water as diluent. Methods: 60 female patients with a diagnosis of Superficial Venous Insufficiency CEAP C1 were included in the study, divided into two groups, to which Sclerotherapy with Polidocanol mixed with water and air was applied. A follow-up was carried out for four weeks where information from the patient was collected regarding the improvement of symptoms before starting treatment and the adverse effects of Polidocanol with both therapies. Results: Within the complications of both treatments, only Matting was reported in a mild range during the first week. The only symptom reported as severe was pain in sclerotherapy with polidocanol mixed with air. The other signs and symptoms were reported within the moderate range, which decreased to mild between the second and third week, finding no reports at the fourth week. The only complication reported was Matting in sclerotherapy with polidocanol mixed with air. Conclusion: No significant differences were found in the degree of satisfaction with the efficacy of the treatment, the adverse effects, the way in which the drug is administered between both sclerotherapy treatments, the satisfaction ranges ranging from 43 to 70%. (AU)
Subject(s)
Humans , Female , Sclerosing Solutions/therapeutic use , Venous Insufficiency/therapy , Sclerotherapy/methods , Polidocanol/therapeutic use , Sclerosing Solutions/adverse effects , Sclerotherapy/adverse effects , Treatment Outcome , Hyperpigmentation/chemically induced , Lower Extremity/blood supply , Polidocanol/adverse effectsABSTRACT
Abstract: Background: Varicose veins and the complications of venous disease are common disorders in humans. Objective: To study the effects of bleomycin as a potential new sclerosing agent and its adverse events in treating varicose veins. Methods: Bleomycin-loaded liposomes 0.1ml was injected in the dorsal ear veins of white New Zealand rabbits. Sodium tetradecyl sulfate was used as a positive control. Normal saline was used as negative control. The blood vessels of the treated ears were photographed before and at one hour and two, eight and 45 days after treatment. Biopsies from the treated areas were obtained for histological examination. Blood samples were collected to determine any possible toxicity. Results: Bleomycin by itself was ineffective; therefore, liposomes were used as a vector to deliver bleomycin to the vein lumen. Subsequently, bleomycin started showing its sclerosing effects. Toxicity monitoring showed no apparent hematologic, pulmonary, hepatic or renal toxicities. This study revealed that bleomycin induced vasculitis, which led to vascular occlusion, which was observed on day 1 and day 8. No bleomycin-related injury was noted by histopathological examination of lung sections. The calculation of the lung/body weight coefficient indicated that edema was present in the experimental groups compared with the negative and positive controls. Study limitations: Relatively small number of experimental animals used. Conclusions: This study showed that bleomycin-loaded liposomes were able to induce vasculitis and vascular occlusion without any toxicity or complications. It might be useful, hence, to treat patients suffering from Varicose veins and other ectatic vascular diseases with this agent.
Subject(s)
Animals , Rabbits , Sclerosing Solutions/pharmacology , Sodium Tetradecyl Sulfate/administration & dosage , Varicose Veins/therapy , Bleomycin/pharmacology , Sclerotherapy/methods , Antibiotics, Antineoplastic/administration & dosage , Sclerosing Solutions/administration & dosage , Sclerosing Solutions/adverse effects , Vasculitis/chemically induced , Vasculitis/drug therapy , Veins/drug effects , Bleomycin/administration & dosage , Disease Models, Animal , Drug Evaluation, Preclinical , Injections, Intravenous , LiposomesABSTRACT
Las várices gástricas están presentes en cerca de un tercio de los pacientes con hipertensión portal y el sangrado de las mismas representa una causa significativa de mortalidad. El tratamiento de primera línea es la obturación con N-butil-2-cianoacrilato, que si bien es seguro no está libre de complicaciones. Presentamos el caso de un paciente de 61 años de edad con antecedente de cirrosis criptogénica que se presentó a la consulta febril, taquicárdico e hipoxémico después de la obturación endoscópica con N-butil-2-cianoacrilato. Las imágenes mostraron embolia pulmonar bilateral del material obturante. El objetivo de este trabajo es destacar las manifestaciones clínicas y las imágenes de esta situación para ayudar a su diagnóstico precoz y diferenciarla de otras entidades que requieren un tratamiento específico.
Gastric varices occur in one-third of patients with portal hypertension. Bleeding from gastric varices remains a significant cause of death. Currently the first-line of treatment for gastric varices is endoscopic obliteration with N-butyl-2-cyanoacrylate. Though relatively safe, this option has several well-known complications. We report the case of a 61-year-old male patient with cryptogenic cirrhosis, who presented with fever, tachycardia and hypoxemia after endoscopic obliteration with N-butyl-2-cyanoacrylate. Radiographic findings were consistent with pulmonary embolism of the sclerosing substance. The aim of this case report is to emphasize the clinical and radiological findings of this complication in order to distinguish it from other similar medical conditions and prevent a delay in diagnosis.
Subject(s)
Humans , Male , Middle Aged , Pulmonary Embolism/etiology , Sclerosing Solutions/adverse effects , Esophageal and Gastric Varices/therapy , Enbucrilate/adverse effects , Pulmonary Embolism/diagnostic imaging , Angiography , Tomography, X-Ray Computed , Sclerotherapy/adverse effects , Sclerotherapy/methods , Gastroscopy/adverse effects , Gastroscopy/methods , InjectionsABSTRACT
No disponible
Subject(s)
Humans , Male , Adult , Venous Insufficiency/complications , Sclerosing Solutions/adverse effects , Venous Insufficiency/therapy , Risk Factors , Varicose Veins/therapyABSTRACT
OBJECTIVES: Chemical pleurodesis is an important therapeutic tool to control recurrent malignant pleural effusion. Among the various sclerosing agents, iodopovidone is considered effective and safe. However, in a recent study, ocular changes were described after iodopovidone was used in recurrent pneumothorax. The aim of the study was to evaluate the efficacy and morbidity of iodopovidone pleurodesis in an experimental model. METHODS: New Zealand rabbits were submitted to intrapleural injection of iodopovidone at concentrations of 2%, 4% and 10%. Biochemical (lactic dehydrogenase, proteins, triiodothyronine, free thyroxine, urea and creatinine) and immunological (Interleukin-8 [IL-8], VEGF and TGFβ) parameters were measured in the pleural fluid and blood. After 1, 3, 7, 14 and 28 days, groups of animals were euthanized, and macro- (pleura) and microscopic (pleura and retina) analyses were performed. RESULTS: An early pleural inflammatory response with low systemic repercussion was observed without corresponding changes in thyroid or renal function. The higher concentrations (4% and 10%) correlated with greater initial exudation, and maximum pleural thickening was observed after 28 days. No changes were observed in the retinal pigment epithelium of the rabbits. CONCLUSION: Iodopovidone is considered to be an effective and safe sclerosing agent in this animal model. However, its efficacy, tolerance and safety in humans should be further evaluated. .
Subject(s)
Animals , Rabbits , Pleural Effusion, Malignant/therapy , Pleurodesis/methods , Povidone-Iodine/administration & dosage , Sclerosing Solutions/administration & dosage , Cytokines/blood , Enzyme-Linked Immunosorbent Assay , Models, Animal , Pleura/drug effects , Povidone-Iodine/adverse effects , Retinal Pigment Epithelium/drug effects , Sclerosing Solutions/adverse effects , Time FactorsABSTRACT
El fenómeno de Koebner fue descrito en 1877 por Heinrich Koebner como la aparición de lesiones típicas de una determinada dermatosis en áreas de piel sana desencadenadas tras diferentes traumatismos. Presentamos el caso de una mujer de 33 años valorada en nuestra consulta por aparición de lesiones psoriasiformes tras el tratamiento mediante escleroterapia con polidocanol de pequeñas varículas en las extremidades inferiores (AU)
Koebner phenomenon was first described in 1877 as the appearance of psoriatic lesions in the uninvolved skin of psoriatic patients as a consequence of trauma. We report a 33-year-old woman referred to our department for evaluation of multiple psoriasiform skin lesions appearing after sclerotherapy for varicose veins of the legs (AU)
Subject(s)
Humans , Female , Adult , Sclerosing Solutions/adverse effects , Skin Diseases/chemically induced , Psoriasis/diagnosis , Diagnosis, Differential , Varicose Veins/drug therapyABSTRACT
OBJECTIVE: We wanted to evaluate the safety and feasibility of ethanol sclerotherapy for treating craniofacial venous malformations (CVMs). MATERIALS AND METHODS: From May 1998 to April 2007, 87 patients (40 men and 47 women; age range, 2-68 years) with CVMs underwent staged ethanol sclerotherapy (range, 1-21 sessions; median number of sessions, 2) by the direct puncture technique. Clinical follow up (range, 0-120 months; mean follow up, 35 months; median follow up, 28 months) was performed for all the patients. Therapeutic outcomes were established by evaluating the clinical outcome of the signs and symptoms in all patients, as well as the degree of devascularization, which was determined on the follow-up imaging, in 71 patients. RESULTS: A total of 305 procedures with the use of ethanol were performed in 87 patients. Follow-up imaging studies were performed for 71 of 87 patients. Twenty-three (32%) of the 71 patients showed excellent outcomes, 37 patients (52%) showed good outcomes and 11 patients (16%) showed poor outcomes. Ethanol sclerotherapy was considered effective for 60 patients. All the minor complications such as bulla (n = 5) healed with only wound dressing and observation. Any major complication such as skin necrosis did not develop. CONCLUSION: Percutaneous ethanol sclerotherapy is an effective, safe treatment for CVMs.
Subject(s)
Adolescent , Adult , Aged , Child , Child, Preschool , Female , Humans , Male , Middle Aged , Young Adult , Analgesics/administration & dosage , Anti-Infective Agents, Local/adverse effects , Craniofacial Abnormalities/therapy , Ethanol/adverse effects , Feasibility Studies , Follow-Up Studies , Pain/drug therapy , Retrospective Studies , Sclerosing Solutions/adverse effects , Sclerotherapy/adverse effects , Treatment Outcome , Vascular Malformations/therapyABSTRACT
No disponible
Subject(s)
Male , Adult , Humans , Embolization, Therapeutic/adverse effects , Enbucrilate/analogs & derivatives , Esophageal and Gastric Varices/therapy , Gastrointestinal Hemorrhage/therapy , Pulmonary Embolism/etiology , Sclerosing Solutions/adverse effects , Enbucrilate/adverse effectsABSTRACT
No disponible
Subject(s)
Male , Adult , Humans , Embolization, Therapeutic/adverse effects , Enbucrilate/analogs & derivatives , Esophageal and Gastric Varices/therapy , Gastrointestinal Hemorrhage/therapy , Pulmonary Embolism/etiology , Sclerosing Solutions/adverse effects , Enbucrilate/adverse effectsABSTRACT
La escleroterapia convencional con esclerosantes líquidos se utiliza desde hace muchos años en el tratamiento de las malformaciones vasculares venosas, linfáticas y de bajo flujo, siendo eficaz sólo en aquéllas de reducido tamaño como complemento pre o postoperatorio. El uso de esclerosantes líquidos tiene la limitación de la dilución e inactivación progresiva en un gran volumen hemático, de la irregular distribución del esclerosante sobre el endotelio, del manejo del esclerosante una vez inyectado y de su imperceptibilidad al eco-Doppler. A su vez, tanto el etanol como el morruato sódico -esclerosantes más habitualmente utilizados- producen importantes efectos secundarios.Por el contrario, la utilización de esclerosantes, concretamente polidocanol, en microespuma mejora significativamente el procedimiento, ya que la microespuma desplaza la sangre en lugar de mezclarse y diluirse con ella, facilita un reparto homogéneo del esclerosante sobre la superficie endotelial, y finalmente la ecogenicidad de las microburbujas, que la hacen directamente visible junto con su consistencia manejable, hacen que pueda distribuirse más fácilmente a lo largo de la zona tratada. Se comenta la experiencia sobre 50 pacientes con malformaciones vasculares venosas o de bajo flujo, tratadas con esta nueva forma de esclerosante. Asimismo, se revisa y protocoliza el uso de OK432 (picibanil) como tratamiento esclerosante de elección de las malformaciones vasculares linfáticas, especialmente las macroquísticas (AU)
Subject(s)
Adolescent , Adult , Female , Male , Middle Aged , Child , Humans , Sclerosing Solutions/therapeutic use , Sclerotherapy/methods , Peripheral Vascular Diseases/therapy , Sclerosing Solutions/adverse effects , Picibanil/therapeutic useABSTRACT
OBJETIVO: Avaliar a resposta biológica que o oleato de etanolamina possa desencadear na parede de veias superficiais normais de cäes. MÉTODOS: Utilizados 39 cäes, sem raça definida, adultos, machos, com peso variando entre 10 a 18 kg, distribuídos de modo aleatório em três grupos: grupo 1, avaliados após 7 dias, grupo 2, 14 dias e grupo 3, 21 dias. O procedimento foi realizado em duas fases. A primeira constou da injeçäo de 2 ml do oleato de monoetanolamina a 5 por cento, por punçäo única na veia cefálica do membro torácico do cäo. A segunda, realizada 7, 14 e 21 dias após, constou da retirada da peça operatória, tendo sido executada em três tempos diferentes, conforme o grupo a que pertencia o animal. As veias contralaterais foram extraídas como controle. Para estudo histológico utilizaram-se os métodos de hematoxilina-eosina e tricrômio de Masson. RESULTADOS: A trombose venosa e a organizaçäo do trombo ocorreram em todos animais estudados. A recanalizaçäo do trombo näo foi observada de modo estatisticamente significante, até 21 dias de exame. Encontrou-se lesäo de túnica média, que näo foi acompanhada de correspondente processo inflamatório. Na túnica adventícia este processo foi visto nos três períodos de tempo estudados. Depósitos de hemossiderina em fagócitos ocorreram aos 14 e 21 dias de experimento. Extravasamento de esclerosante foi observado somente na primeira semana de estudo. Material hialino fibrinóide foi encontrado aos 21 dias de experimento. CONCLUSÕES: O oleato de etanolamina em contato com a parede interna da veia superficial produziu trombose venosa, a qual se organizou em todos os casos, näo se observando sua recanalizaçäo durante o tempo deste ensaio. Houve lesäo da túnica média venosa em todos animais estudados, sem que houvesse processo inflamatório reativo nesse local. Na túnica adventícia venosa surgiu processo inflamatório, além de sinais de extravasamento do esclerosante, da presença de hemossiderina e de material hialino externos à veia.