title: The effect of nitroglycerin ointment on great saphenous vein targeted venous access site diameter with endovenous laser treatment.
abstract: OBJECTIVE
  To assess the effect of topically applied nitroglycerin (NTG) ointment (2%) on preoperative targeted venous access site great saphenous vein (GSV) diameter in patients undergoing endovenous laser treatment (ELT).
  
  
  METHODS
  In this double-blinded randomized study design, 75 patients received either (A) treadmill ambulation only, (B) topically applied NTG ointment only, or (C) topically applied NTG ointment + treadmill ambulation. Targeted venous access vein diameters were measured before therapeutic intervention and then repeated after approximately 30 min following pretreatment intervention. Presence of venospasm and the number of ultrasound-guided venous access attempts during each ELT procedure were assessed during the study.
  
  
  RESULTS
  The mean pretreatment vein diameter was 2.6 mm (range 0.9-4.9 mm). The post-treatment percentage change in vein diameter for group A (treadmill ambulation only) was +2.7% (P = 0.403), whereas group B (NTG only) and group C (NTG + treadmill ambulation) demonstrated significant venodilatation of +69.0% (P < 0.0001) and +51.7% (P < 0.0001), respectively. Statistical analysis of variances and multivariate linear regression model revealed topically applied NTG ointment and 'C' classification of clinical, aetiological, anatomical and pathological elements (CEAP) were each significant predictors for venodilatation percentage change (P < 0.001 and = 0.028, respectively).
  
  
  CONCLUSIONS
  Pretreatment with topically applied NTG ointment (2%) produced a statistically significant, as well as subjective clinically significant venodilatation change in the targeted venous access site diameter of patients undergoing ELT of the GSV in this study.
authors.affiliation: Hogue Vein Institute, Maple Grove, MN, USA. drhogue@drhogue.com
authors.forename: R S
authors.initials: RS
authors.lastname: Hogue
authors.forename: M W
authors.initials: MW
authors.lastname: Schul
authors.forename: C F
authors.initials: CF
authors.lastname: Dando
authors.forename: B E
authors.initials: BE
authors.lastname: Erdman
mesh_terms: D000287:Administration, Topical; D004311:Double-Blind Method; D006801:Humans; D053685:Laser Therapy; D005996:Nitroglycerin / Q000008:administration & dosage*; D009824:Ointments; D011300:Preoperative Care; D011446:Prospective Studies; D012501:Saphenous Vein / Q000000981:diagnostic imaging / Q000187:drug effects* / Q000503:physiopathology / Q000601:surgery*; D016896:Treatment Outcome; D014463:Ultrasonography; D014481:United States; D014664:Vasodilation / Q000187:drug effects*; D014665:Vasodilator Agents / Q000008:administration & dosage*; D014689:Venous Insufficiency / Q000000981:diagnostic imaging / Q000503:physiopathology / Q000601:surgery*; D016138:Walking
chemical_list: D009824:Ointments; D014665:Vasodilator Agents; D005996:Nitroglycerin