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Jornal Vascular Brasileiro 2017Ulcers are the end result of varicose veins associated with reflux in saphenous veins.
BACKGROUND
Ulcers are the end result of varicose veins associated with reflux in saphenous veins.
OBJECTIVE
To demonstrate the possibility of combining two procedures, foam sclerotherapy of saphenous veins and skin grafting, to treat patients with venous ulcers related to reflux in saphenous vein.
METHODS
20 limbs were treated in 20 patients. All patients had ulcers related to saphenous vein reflux. We performed the grafting with expanded skin, followed by administration of ultrasound guided polidocanol foam sclerotherapy in veins associated with ulcers, accessed by puncture or dissection of the vein.
RESULTS
In all cases there was improvement of ulcer-related symptoms and healing of the lesion. In 11 cases we achieved full skin grafting viability. In four cases there was healing of about 50% of the lesion and in the other five cases approximately 75% of the lesion healed. The first control ultrasonographic examination revealed complete sclerosis of the vessels treated in 19 of 20 cases, with partial sclerosis in one case, but no detectable reflux. The second ultrasonographic examination performed at 45 days showed complete sclerosis in 15 cases. In five cases there was partial sclerosis, without detectable reflux in three and with reflux in isolated segments associated with varicose veins in two. The most common complication was pigmentation along vein paths, observed in 13 patients. In one case there was asymptomatic thrombosis of muscle veins of the leg.
CONCLUSION
This combination of procedures is a valid option, with the potential to provide quicker and less expensive treatment.
PubMed: 29930660
DOI: 10.1590/1677-5449.008217 -
Journal of Cutaneous and Aesthetic... 2022Pyogenic granuloma is a commonly occurring inflammatory hyperplasia involving skin and mucous membranes. Various modalities of treatment have been used to treat pyogenic...
INTRODUCTION
Pyogenic granuloma is a commonly occurring inflammatory hyperplasia involving skin and mucous membranes. Various modalities of treatment have been used to treat pyogenic granuloma. However, there is an increased risk of intraoperative bleeding and recurrence of pyogenic granuloma following surgical treatment of pyogenic granuloma. Therefore, sclerotherapy has evolved as an effective alternative treatment modality in excellent safety and efficacy.
AIMS AND OBJECTIVES
The aim of this study was to assess the safety and efficacy of 3% polidocanol in liquid form in pyogenic granuloma as a sclerosant.
SETTINGS AND DESIGN
This was a retrospective study of cases treated between March 2019 and February 2020 at two different private institutes.
MATERIALS AND METHODS
The study included 30 patients with 30 pyogenic granulomas treated with 3% polidocanol liquid. Individuals with comorbid conditions such as diabetes, hypertension, thyroid disorders, and those who were on medications were excluded from the study. Two units of 3% polidocanol solution were injected with an insulin syringe at the base of the lesion. Changes in lesions and adverse events were recorded and injections were repeated after a gap of 2 weeks if needed.
RESULT
In 28 patients, there was complete resolution of the lesion within 4 weeks and 2 patients received a second injection of polidocanol. All the patients tolerated the procedure and the lesions resolved without any significant sequelae.
DISCUSSION
The advantages of 3% polidocanol sclerotherapy are that it is a safe, easy, effective, and minimally invasive procedure with little discomfort to the patient and very minimal complications as compared with other modalities.
CONCLUSION
Polidocanol 3% solution is an effective sclerosant for the treatment of pyogenic granuloma.The aim of this study was to assess the safety and efficacy of 3% polidocanol in the liquid form in PG as a sclerosant.
PubMed: 36561400
DOI: 10.4103/JCAS.JCAS_119_21 -
Frontiers in Pediatrics 2022The aim of this study was to investigate the efficacy of polidocanol against venous malformations (VMs).
OBJECTIVE
The aim of this study was to investigate the efficacy of polidocanol against venous malformations (VMs).
METHODS
Studies reporting the treatment of VMs using polidocanol (published until February 15, 2020) were reviewed in the Embase and PubMed databases. After excluding the same literature, part of the studies were excluded by reading the title, abstract, full text. Eleven studies (with 287 participants) that fulfilled the inclusion criteria were included. Systematic meta-analysis was performed using Reviews Manager 5.2, and a fixed-effects model was used to calculate the pooled effective rate of polidocanol against VMs and the 95% confidence intervals (CI).
RESULTS
Lesion reduction of more than 50% was considered effective. A total of 287 patients were treated, and treatment in 271 was considered effective. The efficacy of polidocanol was 0.89 (95% CI = 0.83-0.93). Heterogeneity among the studies was small ( = 0%, = 0.47). T The funnel plot was roughly symmetric.
CONCLUSION
Our study suggested that polidocanol is effective in the treatment of VMs. VMs at different sites can be treated without serious complications. Therefore, we have reason to believe that polidocanol is a safe and an effective drug for VMs.
PubMed: 35967557
DOI: 10.3389/fped.2022.925318 -
Journal of Vascular Surgery May 2014
Topics: Female; Humans; Male; Polidocanol; Polyethylene Glycols; Sclerosing Solutions; Sclerotherapy; Sodium Tetradecyl Sulfate; Varicose Ulcer; Venous Thrombosis; Wound Healing
PubMed: 24406091
DOI: 10.1016/j.jvs.2013.11.084 -
JVS-vascular Science 2022Fatal allergic responses and cardiac arrhythmias have been reported with the intravenous (IV) administration of polidocanol. We sought to identify the physiologic...
OBJECTIVE
Fatal allergic responses and cardiac arrhythmias have been reported with the intravenous (IV) administration of polidocanol. We sought to identify the physiologic mechanism of systemic cardiovascular response after transcervical (TC) and IV administration of polidocanol.
METHODS
We continuously monitored blood pressure (BP) and heart rate using an arterial line during IV and intraperitoneal (IP) administration of polidocanol solution (PS) and polidocanol doxycycline solution in female rats and TC and IP administration of polidocanol foam (PF) and PDF (TC only) in female baboons. We performed TC procedures using a catheter with (pressurized) and without (nonpressurized) balloon inflation. Baboons also underwent monitoring during IV PS administration with and without pretreatment with antihistamines. We performed cardiac echo and electrocardiograms during selected experiments. We defined a refractory hypotension as a sustained decrease of more than 30% from baseline that prevented delivery of the target dose.
RESULTS
We found a dose-related increase in the proportion of baboons that developed refractory hypotension during TC administration of 5% PDF and PF, an effect confined to pressurized administration. The infusion of 0.5% PS in rats induced a rapid and dramatic refractory hypotension. The inclusion of doxycycline did not improve or deteriorate these outcomes, and doxycycline solution or saline (control) alone did not affect BP. All five female baboons that received up to 20 mL of 1% PS (200 mg) developed refractory hypotension. Pretreatment with diphenhydramine, ranitidine, or both did not block the refractory hypotension induced by IV administration of 1% PS (100 mg). In contrast, only one of the six female baboons treated with IP PF 400 mg developed a decrease of more than 30% in BP, and this response was not sustained. Cardiac echocardiography done in four baboons during TC treatment demonstrated a decrease in cardiac output as the physiologic mechanism of hypotension. We did not observe important changes on the electrocardiograms.
CONCLUSIONS
Adverse cardiovascular effects of polidocanol treatment occur owing to a direct myocardial effect of polidocanol and not as a result of a hypersensitivity reaction. Pressurized TC administration of PF results in refractory hypotension owing to endometrial vascular uptake of polidocanol and not as a result of uptake from peritoneal surfaces.
PubMed: 36439699
DOI: 10.1016/j.jvssci.2022.08.002 -
Journal of Orthopaedics and... Jun 2013Patellar tendinopathy (PT) presents a challenge to orthopaedic surgeons. The purpose of this review is to revise strategies for treatment of PT MATERIALS AND METHODS: A... (Review)
Review
BACKGROUND
Patellar tendinopathy (PT) presents a challenge to orthopaedic surgeons. The purpose of this review is to revise strategies for treatment of PT MATERIALS AND METHODS: A PubMed (MEDLINE) search of the years 2002-2012 was performed using "patellar tendinopathy" and "treatment" as keywords. The twenty-two articles addressing the treatment of PT with a higher level of evidence were selected.
RESULTS
Conservative treatment includes therapeutic exercises (eccentric training), extracorporeal shock wave therapy (ESWT), and different injection treatments (platelet-rich plasma, sclerosing polidocanol, steroids, aprotinin, autologous skin-derived tendon-like cells, and bone marrow mononuclear cells). Surgical treatment may be indicated in motivated patients if carefully followed conservative treatment is unsuccessful after more than 3-6 months. Open surgical treatment includes longitudinal splitting of the tendon, excision of abnormal tissue (tendonectomy), resection and drilling of the inferior pole of the patella, closure of the paratenon. Postoperative inmobilisation and aggressive postoperative rehabilitation are also paramount. Arthroscopic techniques include shaving of the dorsal side of the proximal tendon, removal of the hypertrophic synovitis around the inferior patellar pole with a bipolar cautery system, and arthroscopic tendon debridement with excision of the distal pole of the patella.
CONCLUSION
Physical training, and particularly eccentric training, appears to be the treatment of choice. The literature does not clarify which surgical technique is more effective in recalcitrant cases. Therefore, both open surgical techniques and arthroscopic techniques can be used.
Topics: Adolescent; Adult; Arthroscopy; Exercise Therapy; Female; High-Energy Shock Waves; Humans; Male; Orthopedic Procedures; Patellar Ligament; Polidocanol; Polyethylene Glycols; Sclerosing Solutions; Tendinopathy; Treatment Outcome; Young Adult
PubMed: 23271268
DOI: 10.1007/s10195-012-0220-0 -
Journal Der Deutschen Dermatologischen... May 2014Venous disorders rank among the most frequent diseases in the German population. Early diagnostic investigation and treatment can prevent their progression and may... (Review)
Review
Venous disorders rank among the most frequent diseases in the German population. Early diagnostic investigation and treatment can prevent their progression and may reduce the risk for secondary diseases. The therapeutic spectrum for varicose veins includes conservative as well as interventional and surgical methods. Because it is minimally invasive and well-tolerated, sclerotherapy represents an important treatment method for venous insufficiency, recurrent varicosis and venous malformations. We review the role of sclerotherapy as a treatment option of chronic venous insufficiency in dermatology.
Topics: Aftercare; Contraindications; Dose-Response Relationship, Drug; Evidence-Based Medicine; Humans; Polidocanol; Polyethylene Glycols; Sclerotherapy; Stockings, Compression; Varicose Ulcer; Varicose Veins
PubMed: 24797742
DOI: 10.1111/ddg.12333 -
Expert Opinion on Investigational Drugs Dec 2009Polidocanol is a liquid surfactant having endothelial cell lytic properties. In the form of a controlled, dispensed microfoam it is administered endovenously as a... (Review)
Review
BACKGROUND
Polidocanol is a liquid surfactant having endothelial cell lytic properties. In the form of a controlled, dispensed microfoam it is administered endovenously as a sclerosing agent in the treatment of varicose veins.
OBJECTIVE
This review summarizes efficacy of polidocanol endovenous microfoam sclerotherapy using a proprietary dispensing system to control foam characteristics and gas content for treating varicose veins.
METHODS
We reviewed in vitro, Phase I, Phase II and limited Phase III data for polidocanol microfoam with a focus on controlled foam formulation in therapy.
RESULTS/CONCLUSIONS
Clinical trials of controlled dispensing of polidocanol microfoam provide evidence of effective treatment of chronic venous insufficiency with low toxicity, minimal risk and few complications.
Topics: Chemistry, Pharmaceutical; Clinical Trials as Topic; Dosage Forms; Embolism, Air; Humans; Injections, Intravenous; Polidocanol; Polyethylene Glycols; Sclerosing Solutions; Sclerotherapy; Varicose Veins; Venous Insufficiency
PubMed: 19912070
DOI: 10.1517/13543780903376163 -
Techniques in Coloproctology Aug 2022The aim of the present study was to evaluate the efficacy and safety of 3% polidocanol foam for treating 2nd-degree haemorrhoids.
A multicentre, open-label, single-arm phase II trial of the efficacy and safety of sclerotherapy using 3% polidocanol foam to treat second-degree haemorrhoids (SCLEROFOAM).
BACKGROUND
The aim of the present study was to evaluate the efficacy and safety of 3% polidocanol foam for treating 2nd-degree haemorrhoids.
METHODS
A multicentre, open-label, single-arm, phase 2 trial involving 10 tertiary referral centres for haemorrhodal disease (HD) was performed. Between January and June 2019, patients with 2nd-degree haemorrhoids were prospectively included in this study. The primary outcome was to establish the success rate after one sclerotherapy session in terms of complete resolution of bleeding episodes one week after the injection. The Hemorrhoidal Disease Symptom Score (HDSS), the Short Health Scale for HD (SHS-HD) score and the Vaizey incontinence score were used to assess symptoms and their impact on quality of life and continence. Pain after the procedure, subjective symptoms and the amount and type of painkillers used were recorded. Patients were followed up for 1 year.
RESULTS
There were 183 patients [111 males; 60.7%, mean age 51.3 ± 13.5 (18-75) years]. Complete resolution of bleeding was reached in 125/183 patients (68.3%) at 1 week and the recurrence rate was 12% (15/125). Thirteen patients (7.4%) underwent a second sclerotherapy session, while only 1 patient (1.8%) had to undergo a third session. The overall 1-year success rate was 95.6% (175/183). The HDSS and the SHS score significantly improved from a median preoperative value of 11 and 18 to 0 and 0, respectively (p < 0.001). There were 3 episodes of external thrombosis. No serious adverse events occurred.
CONCLUSIONS
Sclerotherapy with 3% polidocanol foam is a safe, effective, painless, repeatable and low-cost procedure in patients with bleeding haemorrhoids.
Topics: Adolescent; Adult; Aged; Female; Hemorrhoids; Humans; Male; Middle Aged; Polidocanol; Quality of Life; Sclerotherapy; Treatment Outcome; Young Adult
PubMed: 35334004
DOI: 10.1007/s10151-022-02609-w -
Cell Reports Dec 2020There is an increasing appreciation for the heterogeneity of myeloid lineages in the lung, but relatively little is known about populations specifically associated with...
There is an increasing appreciation for the heterogeneity of myeloid lineages in the lung, but relatively little is known about populations specifically associated with the conducting airways. We use single-cell RNA sequencing, flow cytometry, and immunofluorescence to characterize myeloid cells of the mouse trachea during homeostasis and epithelial injury/repair. We identify submucosal macrophages, similar to lung interstitial macrophages, and intraepithelial macrophages. Following injury, there are early increases in neutrophils and submucosal macrophages, including M2-like macrophages. Intraepithelial macrophages are lost after injury and later restored by CCR2 monocytes. We show that repair of the tracheal epithelium is impaired in Ccr2-deficient mice. Mast cells and group 2 innate lymphoid cells are sources of interleukin-13 (IL-13) that polarize macrophages and directly influence basal cell behaviors. Their proximity to the airway epithelium establishes these myeloid populations as potential therapeutic targets for airway disease.
Topics: Animals; Cells, Cultured; Cytokines; Epithelial Cells; Epithelium; Female; Homeostasis; Lung; Lung Injury; Macrophages, Alveolar; Male; Mice; Mice, Inbred C57BL; Mice, Knockout; Models, Animal; Monocytes; Myeloid Cells; Polidocanol; Receptors, CCR2; Regeneration; Sequence Analysis, RNA; Single-Cell Analysis; Trachea
PubMed: 33378665
DOI: 10.1016/j.celrep.2020.108553