title: Significant endothelin release in patients treated with foam sclerotherapy.
abstract: BACKGROUND
  Foam sclerotherapy has been proven to be a safe and effective treatment for superficial venous insufficiency, but transient visual and neurologic disturbances continue to be reported. These side effects have been theorized to be related to the presence of air or gases in the sclerosing foam that results in "bubble" migration into the cerebral circulation. We present a differing hypothesis that significant amounts of endothelin are released from the treated veins, amounts capable of causing these complications.
  
  
  METHODS
  We tested the release of endothelin 1 (ET-1) in 12 rats after sclerotherapy with sodium tetradecyl sulfate (STS) in liquid and foam preparations. In 11 human subjects, we measured ET-1 in systemic circulation and in a draining vein after foam sclerotherapy with polidocanol.
  
  
  RESULTS
  Rats treated with STS showed a significant increase in ET-1 levels 1 and 5 minutes after foam sclerotherapy. Patients treated with foam sclerotherapy showed a marked increase in ET-1 levels that correlated significantly with local ET-1 levels.
  
  
  CONCLUSIONS
  Evidence of ET-1 release represents a plausible relationship explaining neurologic and visual disturbances reported after sclerotherapy.
authors.affiliation: Studio Medico Flebologico, Firenze, Italy. info@venevaricose.it
authors.forename: Alessandro
authors.initials: A
authors.lastname: Frullini
authors.forename: Maria Chiara
authors.initials: MC
authors.lastname: Barsotti
authors.forename: Tatiana
authors.initials: T
authors.lastname: Santoni
authors.forename: Emiliano
authors.initials: E
authors.lastname: Duranti
authors.forename: Silvia
authors.initials: S
authors.lastname: Burchielli
authors.forename: Rossella
authors.initials: R
authors.lastname: Di Stefano
mesh_terms: D000704:Analysis of Variance; D000818:Animals; D004195:Disease Models, Animal; D019332:Endothelin-1 / Q000378:metabolism*; D005740:Gases; D006801:Humans; D000077423:Polidocanol; D011092:Polyethylene Glycols / Q000008:administration & dosage*; D051381:Rats; D012597:Sclerosing Solutions / Q000008:administration & dosage*; D015911:Sclerotherapy / Q000379:methods*; D012981:Sodium Tetradecyl Sulfate / Q000008:administration & dosage*; D014648:Varicose Veins / Q000628:therapy*
chemical_list: D019332:Endothelin-1; D005740:Gases; D012597:Sclerosing Solutions; D000077423:Polidocanol; D011092:Polyethylene Glycols; D012981:Sodium Tetradecyl Sulfate