title: Infusion of foam sclerosants results in a distance-dependent procoagulant activity, haemoconcentration and elevation of D-dimer levels.
abstract: OBJECTIVE
  To investigate the biological effects of foam sclerotherapy in vivo.
  
  
  METHODS
  Ultrasound-guided sclerotherapy was performed using a 3% sodium tetradecyl sulphate or polidocanol. A total of 15 mL of foam was injected. Samples were collected from antecubital veins, target saphenous veins and the adjoining deep veins before, immediately after and 1 hour after the procedure. Saphenous vein samples were also taken sequentially at set 15 cm intervals. Clotting times, D-dimer, cell counts and biochemical parameters were measured. D-dimer levels were repeated one week later.
  
  
  RESULTS
  Forty procedures were performed. Systemic clotting times were not affected by the procedure. Injection of 0.5 mL of foam 5 cm away from the relevant junctions resulted in procoagulant activity in the adjoining deep veins (sodium tetradecyl sulphate) and the target saphenous veins (sodium tetradecyl sulphate and polidocanol). The procoagulant effect in the target veins reached a peak at 15 cm but normalised at 45 cm. D-dimer levels were significantly increased 1 hour after treatment with either agent and remained elevated one week later. Sodium tetradecyl sulphate and to a lesser degree polidocanol induced biochemical changes consistent with haemoconcentration.
  
  
  CONCLUSIONS
  Infusion of foam sclerosants results in a distance-dependent procoagulant activity in the exposed vessels. Foam sclerotherapy results in haemoconcentration and elevation of D-dimer.
authors.affiliation: Dermatology, Phlebology and Fluid Mechanics Research Laboratory, St Vincent's Centre for Applied Medical Research, Sydney, Australia Haematology Research Laboratory, St Vincent's Centre for Applied Medical Research, Sydney, Australia University of New South Wales, Sydney, Australia.
authors.forename: D E
authors.initials: DE
authors.lastname: Connor
authors.affiliation: Haematology Research Laboratory, St Vincent's Centre for Applied Medical Research, Sydney, Australia University of New South Wales, Sydney, Australia.
authors.forename: J E
authors.initials: JE
authors.lastname: Joseph
authors.affiliation: Haematex Research, Hornsby, Australia.
authors.forename: T
authors.initials: T
authors.lastname: Exner
authors.affiliation: Haematology Research Laboratory, St Vincent's Centre for Applied Medical Research, Sydney, Australia University of New South Wales, Sydney, Australia.
authors.forename: D D F
authors.initials: DD
authors.lastname: Ma
authors.affiliation: Dermatology, Phlebology and Fluid Mechanics Research Laboratory, St Vincent's Centre for Applied Medical Research, Sydney, Australia Haematology Research Laboratory, St Vincent's Centre for Applied Medical Research, Sydney, Australia University of New South Wales, Sydney, Australia kparsi@stvincents.com.au.
authors.forename: K
authors.initials: K
authors.lastname: Parsi
mesh_terms: D000328:Adult; D000368:Aged; D001772:Blood Cell Count; D005260:Female; D005338:Fibrin Fibrinogen Degradation Products / Q000032:analysis*; D006801:Humans; D008297:Male; D008875:Middle Aged; D010314:Partial Thromboplastin Time; D000077423:Polidocanol; D011092:Polyethylene Glycols / Q000009:adverse effects* / Q000494:pharmacology / Q000627:therapeutic use; D012501:Saphenous Vein / Q000000981:diagnostic imaging; D012597:Sclerosing Solutions / Q000009:adverse effects* / Q000494:pharmacology / Q000627:therapeutic use; D015911:Sclerotherapy / Q000009:adverse effects* / Q000379:methods; D012981:Sodium Tetradecyl Sulfate / Q000009:adverse effects* / Q000494:pharmacology / Q000627:therapeutic use; D019851:Thrombophilia / Q000139:chemically induced*; D018616:Ultrasonography, Doppler, Duplex; D018084:Ultrasonography, Interventional
chemical_list: D005338:Fibrin Fibrinogen Degradation Products; D012597:Sclerosing Solutions; C036309:fibrin fragment D; D000077423:Polidocanol; D011092:Polyethylene Glycols; D012981:Sodium Tetradecyl Sulfate
keywords: D-dimer; Foam sclerotherapy; blood cells; cardiac enzymes; coagulation; sclerosants