title: Dose- and time-dependent liquid sclerosant effects on endothelial cell death.
abstract: BACKGROUND
  Intravenous sclerotherapy solutions can induce endothelial cell death.
  
  
  OBJECTIVE
  The objective was to determine the relationship between sclerosant concentration and minimum contact time required for in endothelial cell death.
  
  
  METHODS
  Cultured bovine aortic endothelial cells were exposed to a broad range of concentrations of two liquid sclerosants, polidocanol and sodium tetradecyl sulfate. Fluorescence microscopy was used to study cells using dyes specifically indicating changes in intracellular calcium levels, nitric oxide production, and loss of cell membrane integrity after sclerosant exposure. Fluorescence intensity measurements were used to identify the timing of cell death.
  
  
  RESULTS
  Calcium signaling and nitric oxide pathways were activated by the administration of the sclerosants and were followed by cell death. The time to the activation and the cell death was dependent on the concentration of sclerosants. At 0.3% polidocanol or 0.1% sodium tetradecyl sulfate, cell death occurred within 15 minutes. At less than 0.003% polidocanol and at 0.005% sodium tetradecyl sulfate, cells remained alive after 60 minutes.
  
  
  CONCLUSIONS
  Both sclerosants rapidly led to cell death at sufficiently high concentrations. At low sclerosant concentrations, cell viability was maintained beyond the recording time of the experiment. The timing of endothelial cell death is predictable based on sclerosant concentration during exposure.
authors.affiliation: Department of Anesthesiology and Intensive Care, Hamamatsu University School of Medicine, Hamamatsu, Shizuoka, Japan.
authors.forename: Shunji
authors.initials: S
authors.lastname: Kobayashi
authors.forename: Steven
authors.initials: S
authors.lastname: Crooks
authors.forename: David M
authors.initials: DM
authors.lastname: Eckmann
mesh_terms: D000818:Animals; D001011:Aorta / Q000166:cytology; D002417:Cattle; D016923:Cell Death / Q000187:drug effects*; D002478:Cells, Cultured; D004730:Endothelium, Vascular / Q000187:drug effects*; D008856:Microscopy, Fluorescence; D000077423:Polidocanol; D011092:Polyethylene Glycols / Q000008:administration & dosage / Q000494:pharmacology*; D012597:Sclerosing Solutions / Q000008:administration & dosage / Q000494:pharmacology*; D015398:Signal Transduction; D013194:Staining and Labeling; D013997:Time Factors
chemical_list: D012597:Sclerosing Solutions; D000077423:Polidocanol; D011092:Polyethylene Glycols