title: In vitro effects of detergent sclerosants on coagulation, platelets and microparticles.
abstract: OBJECTIVE
  To investigate the in vitro effects of Sodium Tetradecyl Sulphate (STS) and Polidocanol (POL) on clotting tests, clotting factors, platelets and microparticles.
  
  
  METHODS
  Platelet rich (PRP) and platelet poor (PPP) plasmas were incubated with varying concentrations of STS and POL. Clotting tests, platelet/plasma turbidity, and microparticle studies were performed. Specimens were mixed with individual factor deficient plasmas and clotting factor activities were studied.
  
  
  RESULTS
  STS at high concentrations (>0.3%) destroyed platelets, microparticles and the clotting factors V, VII and X. It prolonged all clotting tests including prothrombin time (PT), activated partial thromboplastin time (APTT), non-activated partial thromboplastin time (NAPTT), thrombin time (TT), factor Xa clotting time (XACT) and surface activated clotting time (SACT). Higher concentrations of POL were required to achieve some anticoagulant activity. Low sclerosant concentrations shortened XACT and SACT, and induced release of procoagulant platelet derived microparticles. Increased exposure time resulted in increased procoagulant activity. STS at concentrations higher than 0.5% precipitated a complex containing apolipoprotein b and fibrinogen.
  
  
  CONCLUSIONS
  Detergent sclerosants affect the clotting mechanism by interfering with clotting factor activities, procoagulant phospholipids and platelet derived microparticles. STS has more anticoagulant activity than POL in high concentrations. Low concentration sclerosants demonstrate procoagulant activity.
authors.affiliation: Haematology Research Laboratory, St Vincent's Hospital, Sydney, Australia. kparsi@ozemail.com.au
authors.forename: K
authors.initials: K
authors.lastname: Parsi
authors.forename: T
authors.initials: T
authors.lastname: Exner
authors.forename: D E
authors.initials: DE
authors.lastname: Connor
authors.forename: D D F
authors.initials: DD
authors.lastname: Ma
authors.forename: J E
authors.initials: JE
authors.lastname: Joseph
mesh_terms: D001777:Blood Coagulation / Q000187:drug effects*; D001780:Blood Coagulation Tests; D004305:Dose-Response Relationship, Drug; D015951:Factor Xa / Q000032:analysis; D005434:Flow Cytometry; D006487:Hemostasis / Q000187:drug effects; D006801:Humans; D066298:In Vitro Techniques; D010316:Particle Size; D010974:Platelet Aggregation / Q000187:drug effects*; D000077423:Polidocanol; D011092:Polyethylene Glycols / Q000494:pharmacology*; D012597:Sclerosing Solutions / Q000494:pharmacology*; D012981:Sodium Tetradecyl Sulfate / Q000494:pharmacology*; D013501:Surface-Active Agents / Q000494:pharmacology*; D013997:Time Factors; D014914:Whole Blood Coagulation Time
chemical_list: D012597:Sclerosing Solutions; D013501:Surface-Active Agents; D000077423:Polidocanol; D011092:Polyethylene Glycols; D015951:Factor Xa; D012981:Sodium Tetradecyl Sulfate