Search

Objectives: This study aimed to compare telangiectasias disappearance after sclerotherapy with hypertonic glucose (HG) and different concentrations of sodium tetradecyl sulfate (STS). Methods: Women aged 18–70 years with telangiectasias were included. The primary efficacy endpoint was telangiectasia disappearance. The clearing of vessels was assessed using a six-point scale (from 0 to 5). Results: A total of 116 women completed an 8-week follow-up: 31, 27, 25, and 33 were in the HG 75%, STS 0.05%, STS 0.1%, and STS 0.15% groups, respectively. The median score of vein disappearance was significantly lower in the STS 0.05% (3, 0.25–4), STS 0.1% (3, 1.25–4), and STS 0.15% (4, 2–4) groups than in the HG group (4, 3–5) after 56 days, p =.00002. Conclusion: Sclerotherapy of telangiectasias with 75% HG showed significantly better results than low concentrations of STS. Trial registration: ClinicalTrials.gov NCT04132323. [ABSTRACT FROM AUTHOR]

Objectives: Hereditary hemorrhagic telangiectasia (HHT) is a common inherited condition characterized by mucosal telangiectasias, recurrent epistaxis, and arteriovenous malformations. HHT results in detriment to quality of life. Morbidity and mortality result from severe anemia. Conventional interventions for HHT-related epistaxis include nasal packing, diathermy, lasers, coblation, microdebridement, bevacizumab (topical and systemic), as well as septodermoplasty and nasal closure. Sclerotherapy has been recently described in the literature as a novel approach to HHT-related epistaxis. We hypothesize that sclerotherapy is an effective treatment for HHT-related epistaxis and improves upon the current standard of care for this disease. Methods: A systematic review was conducted to study sclerotherapy for treating HHT-related epistaxis. Ovid MEDLINE, Ovid EMBASE, Scopus, and Web of Science were searched. Articles were evaluated and excluded according to PRISMA guidelines and reviewed by 2 authors. Reported variables included number of injections, months of follow up, changes in Epistaxis Severity Score, previous treatments used to control epistaxis, and post-injection side effects. Results: Seven studies with a total of 196 patients met inclusion criteria. Three studies reported significant improvement as measured by the Epistaxis Severity Score scale. One reported improvement through subjective patient surveys and others used the Bergler-Sadick scale to measure frequency and intensity of epistaxis. All studies reported improvement in HHT-related epistaxis. The lack of uniform reporting measures however precluded formal meta-analysis. Conclusions: Based on limited data, sclerotherapy appears to be effective for treating HHT-related epistaxis and offers promise for treating this recalcitrant condition. However, larger, prospective, multi-centered studies using universally validated instruments for epistaxis are needed to definitively evaluate outcomes from sclerotherapy. [ABSTRACT FROM AUTHOR]

Introduction Retrograde transvenous obliteration (RTO) with the assistance of a balloon (BRTO) or a vascular plug (PARTO) is an established method for treating gastric varices (GVs) secondary to portal hypertension. Most of the available studies on RTO have used lipiodol along with sclerosing agents like ethanolamine oleate or sodium tetradecyl sulfate (STS). We evaluated the safety and efficacy of RTO for treating GVs using STS as a sclerosant without lipiodol. Materials and Methods Sixteen patients (nine men, age range 16–74 years) were included in this retrospective study. Twelve patients presented with acute bleeding, two with chronic bleeding, one with large varices without bleeding, and one with refractory hepatic encephalopathy (HE). BRTO was attempted in 14 patients and PARTO in 2 patients. The technical and clinical success and complications of RTO were studied. Results The RTO procedure was technically successful in 14 (14/16, 87.5%) patients, with 13 (13/14, 93%) obtaining clinical success. One patient died due to the early recurrence of bleeding. Three patients had minor intraprocedural complications. Conclusion Retrograde gastric variceal obliteration using STS is safe and technically feasible with high technical and clinical success and low complication rate.

Mucocele is a common salivary gland lesion which most commonly occurs on the lower lip. Several treatment options are available for its elimination with surgery being the most commonly used method. A 49-year-old male presented with a small, round, painless swelling on the left buccal mucosa since 6 months. A clinical diagnosis of oral mucocele on the left buccal mucosa was made. Due to the inaccessibility of the posterior buccal mucosa region, sclerotherapy with sodium tetradecyl sulfate was planned. The patient did not show any obvious reduction in the size of swelling after 1 week of therapy. Therefore, a second injection was planned. After another 1 week, complete resolution of the lesion was seen with no complications. No recurrence of the lesion has been seen after 6 months of therapy. Due to the various drawbacks of surgical management of oral mucocele, sclerotherapy can be an effective alternative.

Overgrowth syndromes, particularly within the PIK3CA-related overgrowth syndrome (PROS) spectrum, are commonly associated with venous anomalies. The anomalies include spongiform venous malformations and persistent embryonic veins, such as the lateral marginal vein (of Servelle). The anomalous veins pose a significant risk of thromboembolic disease and should be occluded, preferably earlier in life. A thorough understanding of the conditions, anatomy, and interdisciplinary treatment of these complex anomalies is essential for optimal management. This review explores the clinical and imaging diagnosis of overgrowth syndromes and techniques for assessing and treating associated venous anomalies, particularly the endovenous closure of anomalous veins. [ABSTRACT FROM AUTHOR]

Venous malformation (VM) stands as the most prevalent form of vascular malformation, characterized by its diverse morphology. These lesions can manifest in any part of the body, affecting different tissue planes and giving rise to symptoms such as pain, swelling, or physical dysfunction. In the realm of treatment, direct puncture VM sclerotherapy holds its place as the primary approach. This technique involves the administration of a sclerosing agent into the VM channels during contrast phlebography while simultaneously managing the outflow veins through different methods. The process of VM sclerotherapy induces endothelial damage, thrombosis, and fibrosis, resulting in symptom relief through lesion shrinkage. It is crucial to exercise caution techniques and sclerosing agents during VM sclerotherapy to minimize procedural complications, enhance clinical outcomes, and ultimately improve the patient's overall quality of life. [ABSTRACT FROM AUTHOR]

Introduction Retrograde transvenous obliteration (RTO) with the assistance of a balloon (BRTO) or a vascular plug (PARTO) is an established method for treating gastric varices (GVs) secondary to portal hypertension. Most of the available studies on RTO have used lipiodol along with sclerosing agents like ethanolamine oleate or sodium tetradecyl sulfate (STS). We evaluated the safety and efficacy of RTO for treating GVs using STS as a sclerosant without lipiodol. Materials and Methods Sixteen patients (nine men, age range 16–74 years) were included in this retrospective study. Twelve patients presented with acute bleeding, two with chronic bleeding, one with large varices without bleeding, and one with refractory hepatic encephalopathy (HE). BRTO was attempted in 14 patients and PARTO in 2 patients. The technical and clinical success and complications of RTO were studied. Results The RTO procedure was technically successful in 14 (14/16, 87.5%) patients, with 13 (13/14, 93%) obtaining clinical success. One patient died due to the early recurrence of bleeding. Three patients had minor intraprocedural complications. Conclusion Retrograde gastric variceal obliteration using STS is safe and technically feasible with high technical and clinical success and low complication rate. [ABSTRACT FROM AUTHOR]

Pyogenic granuloma is a commonly occurring inflammatory hyperplasia involving the oral cavity. Surgical resection of the lesion is the mainstay treatment of pyogenic granuloma. However, intraoperative bleeding, postoperative infection, and recurrence chances are more with the surgical technique. Therefore, sclerotherapy has evolved as an effective alternative approach, which is simple, noninvasive, with minimal discomfort to the patient and having little recurrences and few complications. This case report is an attempt to highlight the usefulness of sclerotherapy procedure in the management of orogingival pyogenic granuloma, particularly involving the anterior esthetic zone of the oral cavity.

Objective: To assess the clinical efficacy, technical feasibility, and safety profile of percutaneous sclerotherapy utilizing sodium tetradecyl-sulfate foam (STS) as a first-line treatment strategy for aggressive spinal aneurysmal bone cysts (sABCs) presenting with neurological compromise. Materials and methods: Between July 2013 and September 2019, eight consecutive patients (5 males; 3 females; mean age 22±17, range 7–52) underwent fluoroscopic/CT-guided intraosseous sclerotherapy for sABCs. Pain and/or neurological compromise was the primary indications. Procedural data, complications, imaging, and clinical results were analyzed. Results: Technical success was achieved in all cases. Mean procedure time was 25±15 min (range 6–167); 1 to 5 repeat treatment cycles (mean 3.7±1.2) utilizing a mean 2.6mls±1.3 (range 1–6) of agitated 3% STS, with a DLP mean dose of 158±91 mGy*cm (range 62–331) per procedure. One reported a minor complication (pain), but no significant complications. Two patients had persistent neurological deficit due to cord compression despite successful sclerotherapy, requiring surgical resection (and were thereby excluded from the final outcome analysis). The remaining six patients demonstrated a significant reduction in tumor volume (p = 0.028), pain (p = 0.027), and SINS (spinal instability neoplastic score) (p = 0.027) at up to 5 years of follow-up (mean 20 ± 16.7, range 7–51 months). Conclusion: Percutaneous sclerotherapy with STS is a minimally invasive, technically feasible, safe, and effective first-line treatment for primary sABCs causing pain and neurological compromise, alleviating the need for extensive surgery. It is most effective with three or more treatment cycles, in patients with higher SINS, pain scores, or tumor volumes at the initial presentation. [ABSTRACT FROM AUTHOR]

Mucocele is a common salivary gland lesion which most commonly occurs on the lower lip. Several treatment options are available for its elimination with surgery being the most commonly used method. A 49-year-old male presented with a small, round, painless swelling on the left buccal mucosa since 6 months. A clinical diagnosis of oral mucocele on the left buccal mucosa was made. Due to the inaccessibility of the posterior buccal mucosa region, sclerotherapy with sodium tetradecyl sulfate was planned. The patient did not show any obvious reduction in the size of swelling after 1 week of therapy. Therefore, a second injection was planned. After another 1 week, complete resolution of the lesion was seen with no complications. No recurrence of the lesion has been seen after 6 months of therapy. Due to the various drawbacks of surgical management of oral mucocele, sclerotherapy can be an effective alternative. [ABSTRACT FROM AUTHOR]

Purpose: To investigate if the detergent sclerosant sodium tetradecyl sulfate (STS) is deactivated by the lipid-based contrast agent ethiodised oil.Method: 3% STS was mixed with ethiodised oil and room air in a 2:1:4 ratio in two luer lock syringes and a three way connector and agitated to make foam (the Tessari technique) to replicate the clinical use of the products. The assay of STS in the mixture was assessed using the British Pharmacopoeia method. Briefly this is a manual titration method where the solution of STS is mixed with an indicator solution and titrated with hyamine solution of known concentration; the concentration of the STS can then be calculated with the titration results. To further mimic the clinical environment with the presence of blood, the effect of adding increasing amounts of albumin to the STS-ethiodised oil mixture was assessed.Results: The assay of STS in the solution after mixing with ethiodised oil was 3% indicating that the ethiodised oil did not deactivate the STS. The addition of albumin to the STS-contrast mixture resulted in near linear neutralisation of the STS with increasing concentrations in the same quantities as with STS alone.Conclusions: The mixture of the lipid-based contrast agent ethiodised oil with the detergent sclerosant STS did not affect the availability of the sclerosant. The continued use of STS-ethiodised oil in the management of vascular malformations can be supported. [ABSTRACT FROM AUTHOR]

To compare the disappearance of the telangiectasias after sclerotherapy with 75% glucose (HG) versus 0.2% sodium tetradecyl sulfate (STS). This prospective, randomized clinical trial compared the results of sclerotherapy of the telangiectasias with HG and STS. The primary efficacy end point was telangiectasia disappearance within 14, 28, 42, and 56 days following treatment. The clearing of the vessels was assessed using a six-point scale (from 0 to 5). A total of 159 women were treated (81 in the STS group; 78 in the HG group). The median score of the vessels clearing (IQR) was significantly lower in the STS group than in the HG group: 3 (2–4) versus 4 (3–5) after 56 days, p < 0.001. Pigmentation was frequently observed in the STS group (38.3% vs 2.6%; p < 0.001). In conclusion, throughout the entire follow-up period, sclerotherapy of telangiectasias with glucose was significantly superior to that with STS. Moreover, pigmentation and intravascular clots frequently occurred with STS treatment. Russian Registry of Treatment of Chronic Venous Diseases (RRT CVD) ID: VRCVD 1.005. [ABSTRACT FROM AUTHOR]

Pyogenic granuloma is a commonly occurring inflammatory hyperplasia involving the oral cavity. Surgical resection of the lesion is the mainstay treatment of pyogenic granuloma. However, intraoperative bleeding, postoperative infection, and recurrence chances are more with the surgical technique. Therefore, sclerotherapy has evolved as an effective alternative approach, which is simple, noninvasive, with minimal discomfort to the patient and having little recurrences and few complications. This case report is an attempt to highlight the usefulness of sclerotherapy procedure in the management of orogingival pyogenic granuloma, particularly involving the anterior esthetic zone of the oral cavity. [ABSTRACT FROM AUTHOR]

Venous malformations (VMs) are low-flow vascular anomalies that are commonly treated with image-guided percutaneous sclerotherapy. Although many VMs can be safely accessed and treated using ultrasonography and fluoroscopy, some lesions may be better treated with magnetic resonance imaging (MRI)–guided sclerotherapy. The aim of this study is to evaluate the feasibility, efficiency, and outcomes of MRI-guided sclerotherapy of VMs using a 3T MRI system. Six patients with VMs in the neck (n = 2), chest (n = 1), and extremities (n = 3) underwent sclerotherapy with 3T MRI guidance. Feasibility was assessed by calculating the technical success rate and procedural efficiency. Efficiency was evaluated by using planning, targeting, intervention, and total procedure times. Outcomes were assessed by measuring VM volumes before and after sclerotherapy, patient-reported pain scores, and occurrence of complications. Technical success was achieved in all 6 procedures. There was a non-significant 30% decrease in mean VM volume after the procedure (P =.350). The procedure resulted in a decrease in mean pain score (on an 11-point scale) of 2.6 points (P =.003). After the procedure, 4 patients reported complete pain resolution, 1 reported partial pain resolution, and 1 reported no change in pain. Procedural efficiency was consistent with similar sclerotherapy procedures performed at our institution. There were no major or minor complications. 3T MRI guidance is feasible for percutaneous sclerotherapy of VMs, with promising initial technical success rates, procedural efficiency, and therapeutic outcomes without complications. • 3T MRI-guided sclerotherapy is a safe and effective method to treat VMs. • Patient outcomes are similar to sclerotherapy under ultrasound/1.5T MRI guidance. • 3T MRI offers better spatial resolution and procedural visualization. • The procedure is technically feasible and adaptable to interventional practices. [ABSTRACT FROM AUTHOR]

Malignant pleural effusion greatly alters patient's quality of life and pleurodesis significantly improves this index in these patients. Numerous agents have been introduced for pleurodesis. In this study, sodium tetradecyl sulfate (STS) is used for induction of pleurodesis and its efficacy is compared with other sclerosing agents: talc powder and bleomycin. Randomly divided four groups of rats undergone pleurodesis using STS, bleomycin, talc powder, and normal saline. The efficacy of each agent is investigated both microscopic and grossly. The most severe fibrosis was induced by bleomycin and STS respectively and this fibrosis was statistically significant in microscopic evaluation scales. Grossly the most severe fibrosis was induced by bleomycin. Talc Powder and STS caused less fibrosis but the same degree in gross evaluation. This study demonstrates the efficacy of STS for induction of pleurodesis in rat; however, further studies should be done for evaluation of its safety and efficacy in human subjects. [ABSTRACT FROM AUTHOR]

Objective: The management of spinal aneurysmal bone cysts (ABCs) is complex and often requires multimodality therapy, including surgical intervention to stabilize the axial skeleton, and avoid neurologic injury or death. With en bloc resection, ABCs have a recurrence rate of 12%, which increases to >50% with subtotal resection. The use of doxycycline sclerotherapy has been reported to reduce the recurrence rate of non-spinal ABCs to 5% at >24 month follow-up. We retrospectively reviewed our institutional results for sodium tetradecyl sulfate (STS)/doxycycline sclerotherapy and surgical intervention for spinal ABCs, to assess our treatment paradigm for these tumors and inform our future approach to these lesions. Methods: Three cervical, two thoracic and two lumbar spine ABCs were treated in seven patients with spine-exclusive disease at our institution from 2011 to the present. The most common presenting complaint was pain. Each patient was retrospectively reviewed for clinical symptomology, number of treatments, technique and clinical follow-up. Qualitative assessment of improvement was based on the most recent clinical evaluation. Results: The cohort underwent a mean of three treatment sessions (range 2–15). All were treated with STS and/or doxycycline. Five patients underwent surgical intervention at some point, either before or following sclerotherapy. After the last sclerotherapy session, four patients reported stable or improved pain symptoms, while two reported progressive pain that required surgical intervention for that indication. One patient, who underwent both multiple rounds of sclerotherapy and surgical resection, died due to acute on chronic cervical spine collapse with cord compression and inability to control disease. Conclusion: We report our experience in the treatment of spinal column ABCs. Stabilization or improvement in pain was seen in four patients, while the remainder had progressive disease. Our multidisciplinary approach allows patients to receive the most appropriate treatment at presentation and thereafter, for symptom amelioration or spinal stability. Important future goals are to quantitatively assess changes in symptoms over time and to incorporate a reproducible radiographic endpoint for the assessment of treatment efficacy. [ABSTRACT FROM AUTHOR]

Emulsification methods are of interest for numerous fields and those that generate nanoemulsions are, particularly, of great interest for medical applications. This paper presents a new laser-assisted device that may generate pharmaceutical emulsions. One of its advantages is that allows the use of small quantities of solutions, as low as a few hundreds of μl. It also allows to set the number of mixing cycles and mixing speeds. Emulsions of Sodium tetradecyl sulfate (STS) solution in water and oily vitamin A were generated without additional stabilizers. Optical microscopy, dynamic light scattering and surface tension analysis of a pendant drop were employed to compare the unirradiated emulsions with the ones exposed to laser radiation at 532 nm. Results showed that laser radiation decreases and homogenizes droplets dimensions. Furthermore, irradiation increases the stability of the emulsions. The wavelength of laser radiation is selected so that it is not absorbed by molecules in the immiscible solutions. In this way the energy of laser radiation leads to droplet break-up and generation of new, smaller droplets. [ABSTRACT FROM AUTHOR]

Background and objectives Foam sclerotherapy is a clinical procedure for the treatment of unhealthy veins. The aim of this study was to investigate the effect of sulodexide (SUL) on stability of foams prepared using polidocanol (POL) and sodium tetradecyl sulfate (STS) detergents, more specifically with 0.25% aethoxysclerol and 0.2% Fibro-Vein sclerosing solutions. Methods Foams were produced by the Tessari method using three different weight ratios of POL-SUL and STS-SUL (1:0, 1:1, and 1:3). Results The half-life of STS foams resulted as follows: 82 ± 1.6 s, 101.8 ± 2.6 s, and 109.7 ± 2.1 s for 1:0, 1:1, and 1:3 STS-SUL weight ratios, respectively. The same ratios were used for POL foams with the following results: 90.6 ± 3 s, 106.8 ± 2.6 s, and 107.6 ± 2.7 s for 1:0, 1:1, and 1:3 POL-SUL weight ratios, respectively. Conclusion The addition of SUL in sclerosing solutions can prolong the half-life of foams, and it could be potentially used as a foam stabilizer. [ABSTRACT FROM AUTHOR]

Purpose: Cosmetic vein sclerotherapy is increasingly used to treat varicose veins because of its effectiveness and adherence with British Pharmacopoeia specifications. We present the first documented case of ophthalmic artery occlusion resulting in panocular ischemia secondary to intravascular injection of sodium tetradecyl sulfate sclerosant in a young healthy women seeking treatment for prominent facial veins in her forehead. Methods: The patient presented with unilateral sudden loss of vision. Funduscopy demonstrated a pale retina, cherry-red spot, and sclerosant visualized directly at the macula. She underwent emergency treatment for central retinal artery occlusion followed by fundal photographs, fluorescein angiography, and optical coherence tomography. Results: Despite intervention, the vision remained no perception to light. Magnetic resonance imaging, echocardiography, and Doppler ultrasound were unremarkable. The patient later developed neovascular sequelae requiring laser pan-retinal photocoagulation. Conclusion: Widely regarded as safe, and approved by the U.S. Food and Drug Administration, the only published ocular side effects of foam sclerotherapy are transient visual disturbances or temporary scotomas. This case demonstrates irreversible loss of vision as a previously unreported complication. While undoubtedly rare, we believe physicians and surgeons using sclerosant in the orbital adnexa, face, nose, and sinuses should be aware of this sight-threatening complication of injection and counsel potential patients accordingly. [ABSTRACT FROM AUTHOR]

Gastric varices (GVs) are a major complication of portal hypertension in patients with liver cirrhosis. The mortality rate associated with the bleeding from GVs is not low. Balloon‐occluded retrograde transvenous obliteration (BRTO) was first introduced by Kanagawa et al. as a treatment for isolated GVs in 1994. It has been performed most frequently in Asia, especially in Japan. Ethanolamine oleate was the original sclerosant used in the therapy. Since the late 2000s, BRTO using sodium tetradecyl sulfate foam or polidocanol foam as a sclerosant has been performed in many countries other than Japan. Then, early in the 2010s, modified BRTO techniques including vascular plug‐assisted retrograde transvenous obliteration and coil‐assisted retrograde transvenous obliteration were developed as an alternative treatment for GVs. This article provides a historical overview of BRTO using various sclerosants and modified BRTO techniques, such as plug‐assisted retrograde transvenous obliteration and coil‐assisted retrograde transvenous obliteration. [ABSTRACT FROM AUTHOR]

Purpose: The aim of this article is to review the published literature on the use of bleomycin, ethanol and sodium tetradecyl sulfate as sclerosing embolic agents in vascular malformation management and contrast and compare them.Material and methods: Published journal articles on bleomycin, ethanol and sodium tetradecyl sulfate employed in vascular malformation management were reviewed and the results were analyzed.Results: While efficacy has been described for all the sclerosing embolic agents, absolute ethanol appears to be superior compared to others in that cures were routinely documented.Conclusion: Absolute ethanol is highly effective in the permanent eradication and permanent ablation of high-flow and low-flow vascular malformations. [ABSTRACT FROM AUTHOR]

First described by Hullihen in 1844, Pyogenic granuloma (PG) is a benign, exophytic vascular tumor. It is not infective, purulent or granulomatous but a reactive inflammatory mass of blood vessels with few fibroblasts within the mucosa or skin. Without any general agreement, there exist a variety of treatment options (complete surgical resection, cryosurgery, curettage, lasers etc). However, recurrence has been frequently reported. Sclerotherapy in PG (a vascular tumor) is not as commonly reported as in cases of hemangioma.Herein, we present a case of twenty-eight years old female with a clinical diagnosis of PG, treated with intralesional sodium tetradecyl sulfate (STS). Intralesional injection of 0.2 ml of undiluted STS was given for three visits between 10th of January and 21st of February 2016. The lesion healed completely at the patient’s fourth visit and recurrence was not reported till the patient was followed up for one year, i.e February 2017.

Purpose: This study was performed to compare the long-term outcomes of balloon-occluded retrograde transvenous obliteration (BRTO) for gastric varices using ethanolamine oleate (EO) and sodium tetradecyl sulfate (STS).Methods: From January 2002 to June 2015, 142 patients underwent BRTO for the treatment of gastric varices using EO (n = 59) or STS (n = 83). We retrospectively reviewed the follow-up data related to the obliteration of gastric varices, rebleeding, and clinical complications. The cumulative recurrence rates of gastric varices after BRTO in each group were analyzed using the Kaplan-Meier method and compared using the log-rank test.Results: The median follow-up periods were 23.9 (range 0.2-170.7) months in the BRTO with EO group and 19.9 (range 0.2-84.7) months in the BRTO with STS group. Technical success was achieved in 53 of 59 (89.8%) cases in the BRTO with EO group and 80 of 83 (96.4%) cases in the BRTO with STS group. The clinical success rates were 94.9% (56/59) in the BRTO with EO group and 96.4% (80/83) in the BRTO with STS group. The cumulative 1-, 3-, and 5-year recurrence rates for gastric varices were 3.8, 9.4, and 9.4% in the BRTO with EO group and 1.3, 2.5, and 3.8% in the BRTO with STS group, respectively (p = 0.684).Conclusions: BRTO using STS has comparable long-term outcomes to BRTO using EO for gastric varices. [ABSTRACT FROM AUTHOR]

Hemangiomas are hamartomatous proliferations of vascular origin. The prevalence of these lesions is about 7% of all the benign tumors of the body. The clinical appearance of hemangiomas varies depending on the location of the vascular proliferation. Complications though rare, can occur such as ulceration, bleeding either due to trauma or spontaneously as well a pain, making treatment a necessity. Different treatment modalities have been proposed both for cutaneous and oral hemangiomas. These include the use of intralesional injection of sclerosing agents, corticosteroids, and anti-cancer drugs. Laser therapy, using CO2and neodymium-doped yttrium aluminum garnet, has also been utilized. Larger lesions are treated with embolization and surgical excision. A case of hemangioma of the upper lip and labial mucosa in a 9-year-old girl, treated with an intralesional sclerosing agent, is being reported.

Vision loss following sclerotherapy for facial vascular malformations (VMs) is a rare but detrimental complication. Here, we report a case of an 11-year-old boy with acute onset blepharoptosis, ophthalmoplegia, and blindness in his right eye after the 14 th sclerotherapy session (percutaneous intralesional injection of sodium tetradecyl sulfate) for a right facial low-flow VM without orbital involvement. Computed tomography angiography revealed no contrast enhancement in the right ophthalmic artery, superior ophthalmic vein, or extraocular muscles. He presented with the hallmarks of orbital infarction syndrome: Clear signs of anterior and posterior segment ischemia and disrupted arterial flow to the extraocular muscles. His blepharoptosis and eye movement improved 4 months later; however, he remained blind, and phthisis bulbi developed eventually. Thus, sclerotherapy for facial VM-even without orbital involvement--may result in severe ocular and orbital complications.

Hemangiomas are common tumors characterized microscopically by proliferation of blood vessels. The congenital hemangioma is often present at birth and may become more apparent throughout life. They are probably developmental rather than neoplastic in origin. Despite their benign origin and behavior, hemangiomas in the oral cavity are always of clinical importance to the dental profession and require appropriate clinical management. Surgery and other treatment modalities are not always satisfactory and have a higher morbidity, recurrence, and complication rate. This case report presents a case of hemangioma of mandibular left lower region in 47-year-old female and its treatment using sclerosing agent.

Hemangiomas are one of the most common neoplasms of infancy with an estimated prevalence of 1-3% among neonates and 10% among children of 1 year of age. It has a female predominance and occurs more frequently among Caucasians than other racial groups. Sixty percent of hemangiomas arise in the head and neck. In 80% of cases, hemangiomas occur as single lesions. They are probably developmental rather than neoplastic in origin. Despite their benign origin and behavior, hemangioma in the oral cavity is always of clinical importance to the dental profession and requires appropriate clinical management as sometimes it is associated with complications like bleeding and ulceration. Here, we report a case of hemangioma of tongue treated with sodium tetradecyl sulfate, a sclerosing agent.

Objective: To determine the efficacy of sclerotherapy in treating pyogenic granuloma. Methods: The present study was conducted at outpatient Department Dermatology, Unit I, Mayo Hospital, Lahore. 35 patients were enrolled and were injected with 0.1ml of 3% sodium tetradecyl sulfate with the help of an insulin syringe, without local anesthesia, till the point of blanching. Patient was called weekly for two weeks for follow up to see clearance of the lesion and then after 3 months to see any recurrence using a caliper. Results: The mean age of the patients was 28.48±11.64 years. 42.9% patients were males and 57.1% patients were females. Complete clearance of lesion was found in 30 (85.7%) patients whereas 2 (5.7%) patients showed no reduction. Conclusion: Sclerotherapy is an effective procedure for the treatment of pyogenic granuloma patients. [ABSTRACT FROM AUTHOR]

Background: Hemangioma and vascular malformation are benign vascular lesions that often occur in cephalic and cervical region. Currently, surgical resection, laser therapy, angiographic embolization, use of steroids, and sclerotherapy are used as treatments. Case presentation: This study reports three cases of benign vascular lesions that are remarkably treated by sodium tetradecyl sulfate (STS) injection, of which occurred in oral cavity and around the mouth. Three percent of STS was diluted with 0.9 % of normal saline, and it was injected to the lesion site at least once. The result of treatment was evaluated based on clinical findings. Conclusion: Surgical treatment of hemangioma and vascular malformation occurred in oral cavity is not normally used because of esthetic issues and potential hemorrhage. On the other hand, sclerotherapy using STS is an effective therapy compare to surgical treatment. Despite the number of STS injection was different for each patient, all three patients had reached satisfactory level through the treatment with gradual diminution of lesions. [ABSTRACT FROM AUTHOR]

Background: Haemangioma (HM) and venous malformations of the head and neck are formidable lesions as they cause cosmetic deformity and psychological problems. Their surgical excision is difficult and fraught with problems like operative blood loss, incomplete excision, disfigurement and recurrence. Endovascular techniques like sclerotherapy and embolization are increasingly being used in the treatment of these difficult lesions. Objectives: This study was undertaken to analyse the efficacy and safety of endovascular techniques in the treatment of HM and slow flow vascular malformations. Materials and Methods: We retrospectively reviewed the records and clinical photographs of 358 patients of HM and slow flow vascular malformations treated in our institute by endovascular approach over a 15 year period. Pre- and post-treatment photographs were compared and outcomes categorized as complete resolution (>90% reduction), considerable reduction (60-90% reduction), partial reduction (20-60% reduction) and no change (

The effects of addition of ethanol and propan-1-ol on sodium tetradecyl sulfate micelle formation in an aqueous solution are studied via microprobe fluorescence microscopy and conductometry. The critical micelle concentration, quantitative characteristics of micelles, and thermodynamic parameters of micelle formation are determined. Addition of 5-15 vol % of ethanol or 5-10 vol % of propan-1-ol is shown to result in a lower critical micelle concentration than in the aqueous solution, and in the formation of mixed spherical micelles whose sizes and aggregation numbers are less than those for the systems without alcohol. The contribution from the enthalpy factor to the free energy of sodium tetradecyl sulfate micelle formation is found to dominate in mixed solvents, in contrast to aqueous solutions. [ABSTRACT FROM AUTHOR]

Venous malformations are one of the commonest anomalies of the vascular tree and their management has always remained a major challenge. Surgery and other treatment modalities are not always satisfactory and have a higher morbidity, recurrence and complication rate. The author retrospectively analyzed 40 patients of venous malformations who underwent sclerotherapy with sodium tetradecyl sulfate solely or as an adjunct to surgery. The purpose of the study was to evaluate the efficacy and safety of sodium tetradecyl sulfate sclerotherapy in the treatment of venous malformations.

The present study was carried out with an aim to perform a prospective study to establish the role of sodium tetradecyl sulfate (3 %) (STDS) as a safe and effective sclerosant in the management of primary hydrocele. Sclerotherapy was performed with 3 % STDS on an outdoor basis. The amount of sclerosant injected depended on the amount of fluid drained. All patients were given prophylactic antibiotics. Patients were clinically reassessed at 1 week, 1 month, 3 months, and 6 months and earlier if complications occur. The data were analyzed using Statistical Package for Social Sciences Version 15.0. The data have been represented as frequencies and percentages. Chi-square test was used to compare the data. A total of 57 patients with primary vaginal hydrocele gave consent for being enrolled in the study. The age of patients ranged from 18 to 65 years with a mean age of 35.72 ± 13.18 years. The success rate at the end of the study was observed to be 84.2 %. As regards patient satisfaction, in present study, in a limited time period of follow up, all the patients who had a successful procedure were satisfied. Overall, sclerotherapy was observed to be a relatively cost-effective (including both direct and indirect costs) procedure with low complications, high satisfaction, and a high success rate within the limited period of follow-up. [ABSTRACT FROM AUTHOR]

Intramuscular hemangiomas are benign lesions uncommon in the head and neck region. The masseter is the most commonly involved muscle in the craniofacial region. In the pre-auricular region intramuscular hemangiomas are often clinically misdiagnosed as parotid swelling. In the absence of calcifications within the lumen of the lesion, advanced imaging investigations such as ultrasonography (US) and magnetic resonance imaging (MRI) are extremely useful in the diagnosis and treatment planning of such lesions. A case of intramuscular hemangioma occurring in an 8-year-old male patient is presented here. US, Color Doppler US, MRI and post contrast MRI were performed and diagnosis of intramuscular hemangioma in the masseter muscle of the left side was established. The lesion was treated with percutaneous sclerotherapy with no recurrence in a six-month follow-up. [ABSTRACT FROM AUTHOR]

We report a facile synthesis of polypyrrole spheres with controllable sizes, monomer units and conductivities using sodium nitrite and nitric acid in presence of the anionic surfactant sodium tetradecyl sulfate. The rapid synthesis of polypyrrole spheres was accomplished without employing any explicit oxidizing agents. The characterization of polypyrrole (PPy) is carried out using FTIR, XRD, SEM, TEM and TGA while the molecular weight is estimated from the MALDI TOF analysis. The precise tuning of various physicochemical properties is accomplished by altering the concentrations of sodium nitrite and is attributed to the in situ generation of NO 2 . The size of the PPy spheres varies from 45 nm to 350 nm depending upon the concentration of NaNO 2 . The dynamic light scattering studies provide mechanistic insights into the role of sodium nitrite in altering the pyrrole-incorporated micellar size of the surfactant, leading to different diameters of the PPy spheres. The surfactant-induced solubility of PPy is rationalized with the help of the X-ray diffraction patterns. The solution of PPy in dimethylsulfoxide has a remarkable ability of selectively detecting Cu 2+ and Hg 2+ among a host of other bimetallic ions, as inferred from colorimetry and UV–Visible absorption spectroscopy. [ABSTRACT FROM AUTHOR]

Background Our previous studies have demonstrated the tolerability and low side-effect profile of office-based sclerotherapy with sodium tetradecyl sulfate (STS) for treating recurrent epistaxis due to hereditary hemorrhagic telangiectasia (HHT). The objective of this study was to use a prospective randomized trial to determine the effectiveness of sclerotherapy with STS vs standard treatment. Methods This prospective randomized trial (conducted from November 1, 2011, through January 31, 2014) involved 17 patients with recurrent epistaxis due to HHT. We defined standard treatment as continuation of any treatment that the patient had previously undergone, such as moisturization, packing, and cautery. We used a crossover design, so study participants were randomized to either sclerotherapy or standard treatment during the first time period, and then to the other during the second period. The primary outcome measure was frequency and severity of epistaxis, as measured by the epistaxis severity score (ESS). The ESS is a 10-point scale, with higher scores corresponding to more bleeding. Results After controlling for treatment order, bleeding was substantially better controlled after sclerotherapy; the ESS after sclerotherapy was nearly one point lower than after standard treatment (−0.95, 1-sided p = 0.027). Treatment order, baseline ESS, the number of lesions, moisturization practices, and a history of previous blood transfusions did not significantly affect the results. Conclusion This trial demonstrated that sclerotherapy with STS (vs standard treatment) significantly reduced epistaxis due to HHT. [ABSTRACT FROM AUTHOR]

Brief Background: This paper presents two cases of Peripheral Giant Cell Granuloma (PGCG) that were managed by surgical excision after a reduction in size was achieved with a sclerosing agent, sodium tetradecyl sulfate (STS). Materials and Methods: The patients underwent pre-surgical routine blood tests and intraoral periapical radiographs to note the presence of bone loss or other pathology if any. After removal of the local irritants, sclerotherapy was performed with STS to reduce the size of the lesions. Complete surgical excision of the lesion was done by scalpel along with extraction of the neighbouring hopeless teeth in one case. In the latter case, to compensate for the large defect created after the excision, a free mucosal graft from the palate was placed at the defect site. Results: The surgical sites healed uneventfully with no signs of recurrence over the last twenty months of follow up. Conclusion: The early and precise diagnosis of PGCG permits conservative management with less risk for the adjoining teeth and bone. [ABSTRACT FROM AUTHOR]

Purpose: To describe a patient with ophthalmic artery occlusion after sodium tetradecyl sulfate foam injection in the forehead. Methods: In this case report, a description of the clinical examination and imaging findings, including fundus photography, spectral-domain optical coherence tomography, and fluorescein angiography are reported. Results: A 33-year-old white woman presented with severe painless vision loss in the left eye after cosmetic treatment of a forehead vein with sodium tetradecyl sulfate foam. Her visual acuity in the left eye was hand motions, and her fundus revealed diffuse retinal whitening in the macula with the absence of a cherry red spot and disruption of the arteriolar blood supply. Spectral-domain optical coherence tomography revealed intense hyperreflectivity of the inner and outer retina with loss of the foveal contour, and fluorescein angiography revealed delayed filling of the choroidal vasculature and cilioretinal artery with incomplete filling of the retinal arterioles in the late frames consistent with ophthalmic artery occlusion. Conclusion: This case represents a devastating ocular complication after the inadvertent injection of sodium tetradecyl sulfate into a forehead artery, resulting in occlusion of the ophthalmic artery and severe vision loss. [ABSTRACT FROM AUTHOR]

Background: Digital mucous cysts (DMCs) are common tumor of the adjacent distal interphalangeal joint that causes leakage of mucinous material from the joint. There are various treatment modalities for DMCs, among which sclerotherapy has been reported as an effective alternative treatment. Objectives: To evaluate the safety and efficacy of sclerotherapy for DMC. Patients and methods: We retrospectively reviewed 12 patients with DMC treated with sclerotherapy. 0.5% Sodium tetradecyl sulfate 0.2-0.3cc was injected into the pseudocystic lesions after the complete evacuation of mucinous material. Results: Eleven of 12 lesions regressed successfully, including four lesions that resolved after a single treatment. The mean number of treatments was 2.4. The mean follow-up period was 18.3 months after the last treatment. There was one case of recurrence after the last treatment. Complications such as mild edema, inflammation and pain were noted in three patients, which resolved within few days. Conclusions: According to the results of the present study, sclerotherapy is a feasible alternative treatment modality for DMCs. Treatment was well tolerated with few side effects, and resulted in high cure rate. Due to its less invasive nature, high accessibility and favorable outcomes, sclerotherapy should be considered a satisfactory option for the treatment of DMC. [ABSTRACT FROM AUTHOR]

Pyogenic granuloma (PG) is common benign vascular lesion of the skin and mucosa. It is not infective, purulent or granulomatous (as the name might suggest) - rather, a reactive inflammatory mass of blood vessels and a few fibroblasts within the dermis of the skin. The exact cause is not known but multiple factors have been implicated in the etiology of pyogenic granuloma. Various treatment options exist without any consensus, PGs have been treated by cryosurgery, curettage, electrodessication, chemical cautery and lasers. The therapeutic effects of these conservative treatments are limited and recurrence rates are high. Though sclerotherapy is being used extensively for varicose veins, its use as a treatment modality for pyogenic granuloma is not commonly reported. Herein, we present a case of pyogenic granuloma treated by intralesional injection of sodium tetradecyl sulfate without recurrence. [ABSTRACT FROM AUTHOR]

Background The aim of this study was to identify and evaluate adverse clinical outcomes following office-based sclerotherapy using sodium tetradecyl sulfate (STS) for epistaxis due to hereditary hemorrhagic telangiectasias (HHT or Osler-Weber-Rendu). Methods A retrospective chart review of 36 adult patients treated with STS sclerotherapy for severe and/or recurrent epistaxis due to HHT was performed. Results A total of 153 separate treatment sessions were analyzed. Each patient underwent an average of 4.3 sessions with an average of 7 intralesional injections per session. Bleeding during the procedure was experienced by 8 patients with a maximum reported blood loss of 200 mL in 1 patient, but less than 50 mL in all others. Seven patients reported some postinjection pain, which included nasal, cheek, and eye pain. Nasal congestion, sneezing, and vasovagal responses were each noted to occur 2 times. No complications of postprocedural visual loss, deep venous thrombosis/pulmonary embolus, transient ischemic attack (TIA)/stroke, or anaphylaxis were encountered. Conclusion Conventional therapies used in the management of HHT-related epistaxis, such as laser coagulation, septodermoplasty, selective arterial embolization, and Young's occlusion each have specific associated complications, including worsened epistaxis, septal perforation, foul odor, nasal crusting, and compromised nasal breathing. STS is a safe office-based treatment option for HHT-mediated epistaxis that is associated with exceedingly few of the aforementioned serious sequelae. [ABSTRACT FROM AUTHOR]

Symptomatic slow-flow vascular malformations include venous malformations and lymphatic malformations, as well as combined anomalies. Endovascular therapy, consisting mainly of intralesional sclerosant injection, is now accepted as the primary treatment for most of these lesions. Magnetic resonance imaging and ultrasonography supplement physical examination for diagnosis and assessment of the extent of malformation. Endovascular treatment is usually carried out under general anesthesia. Sclerosants for venous malformations include ethanol, 3% sodium tetradecyl sulfate, and bleomycin. Lymphatic malformations can be injected with doxycycline, bleomycin, OK-432, or other sclerosants. Complications of sclerotherapy include tissue necrosis, peripheral nerve injury, hemoglobinuria, deep vein thrombosis, and pulmonary embolism. Although most vascular malformations are not cured, the majority of patients benefit from endovascular treatment. [ABSTRACT FROM AUTHOR]

Background: Haemangioma (HM) and venous malformations of the head and neck are formidable lesions as they cause cosmetic deformity and psychological problems. Their surgical excision is difficult and fraught with problems like operative blood loss, incomplete excision, disfigurement and recurrence. Endovascular techniques like sclerotherapy and embolization are increasingly being used in the treatment of these difficult lesions. Objectives: This study was undertaken to analyse the efficacy and safety of endovascular techniques in the treatment of HM and slow flow vascular malformations. Materials and Methods: We retrospectively reviewed the records and clinical photographs of 358 patients of HM and slow flow vascular malformations treated in our institute by endovascular approach over a 15 year period. Pre-.and post-treatment photographs were compared and outcomes categorized as complete resolution (>90% reduction), considerable reduction (60-90% reduction), partial reduction (20-60% reduction) and no change (<20% reduction). Results: Complete resolution of the lesion was seen in 30% of the patients while 50% patients showed considerable reduction of the swelling. Complications occurred in 6.4% of patients. Conclusion: We conclude that sclerotherapy is an effective and safe treatment modality for these lesions and may be considered as the primary modality in the treatment of these challenging lesions. [ABSTRACT FROM AUTHOR]

In this study, the authors present an analysis of the outcomes of 105 low-flow vascular malformation patients treated over a 6-year period and report specific lesion characteristics that correlate with those vascular malformations that will benefit from sodium tetradecyl sulfate foam sclerotherapy (STS FS) versus surgical resection as well as morphological characteristics of vascular malformations that are associated with a poor response to FS treatment. Improvement in symptoms was documented in 92.9% of patients treated with STS FS. There were no complications. Low-flow vascular malformations that were morphologically characterized by microcystic, septated vessels did not respond to FS, and these vascular malformations are best treated with surgical resection. Primary surgical resection is also the treatment of choice for localized, microcystic, and superficial low-flow vascular malformations. Symptomatic, diffuse, extensive, macrocystic malformations that involve multiple tissue planes and vital structures are best treated with FS. [ABSTRACT FROM PUBLISHER]

Hemangiomas are hamartomatous proliferations of vascular origin. The prevalence of these lesions is about 7% of all the benign tumors of the body. The clinical appearance of hemangiomas varies depending on the location of the vascular proliferation. Complications though rare, can occur such as ulceration, bleeding either due to trauma or spontaneously as well a pain, making treatment a necessity. Different treatment modalities have been proposed both for cutaneous and oral hemangiomas. These include the use of intralesional injection of sclerosing agents, corticosteroids, and anti‑cancer drugs. Laser therapy, using CO2 and neodymium‑doped yttrium aluminum garnet, has also been utilized. Larger lesions are treated with embolization and surgical excision. A case of hemangioma of the upper lip and labial mucosa in a 9‑year‑old girl, treated with an intralesional sclerosing agent, is being reported. [ABSTRACT FROM AUTHOR]

Background: Management of vascular anomalies is extremely challenging and varies according to the nature of the lesion. Traditionally, embolization with the resection of the lesion and autologous immediate reconstruction has been used. The purpose of this report is to present cases successfully using sclerosing solution injections alone. Methods: This paper describes the management of two cases of the mandibular vascular malformations using trans-osseous injection of the sodium tetradecyl sulfate to the periphery of the lesion. The procedure was performed four or five times at two weeks intervals respectively. Imaging was performed using subtraction arteriography and sequential panoramic dental radiographs. Results: Radiological and histological evaluation of the cases showed resolution of the lesions following sclerotherapy alone. Conclusions: Conservative interventional management using trans-osseous injection of sclerosing solution was successful in treating mandibular vascular anomalies. [Copyright &y& Elsevier]

In this double-blind, randomized trial, we compared the clinical efficacy of intralesional vinblastine (VNB) and 3% sodium tetradecyl sulfate (STS) in the treatment of oral Kaposi’s sarcoma (OKS). Subjects with OKS were randomly assigned to receive a single intralesional injection of either VNB or STS, at a standard dose (0.2 mg/cm2). Differences were evaluated by the Mann–Whitney U and Fisher’s exact tests. Sixteen HIV-infected patients were included, eight received VNB and eight received STS; clinical response was evaluated at days 7, 14, and 28 following treatment. Tumor size reduction was 0.68 and 0.61 cm in the VNB and STS groups, respectively (P=0.80). Two VNB patients had complete or partial response whereas four STS subjects had partial responses (P=0.61). Patients in both groups experienced minimal toxicity. We conclude that intralesional vinblastine or STS are adequate for the management of OKS. The benefits of STS are its low cost and ease of use. [ABSTRACT FROM AUTHOR]

Hemangiomas are common tumors characterized microscopically by proliferation of blood vessels. The congenital hemangioma is often present at birth and may become more apparent throughout life. They are probably developmental rather than neoplastic in origin. Despite their benign origin and behavior, hemangiomas in the oral cavity are always of clinical importance to the dental profession and require appropriate clinical management. Surgery and other treatment modalities are not always satisfactory and have a higher morbidity, recurrence, and complication rate. This case report presents a case of hemangioma of mandibular left lower region in 47-year-old female and its treatment using sclerosing agent. [ABSTRACT FROM AUTHOR]