Immediate pathologic effects on the vein wall of foam sclerotherapy.

BACKGROUND: During the past 10 years, sclerotherapy has radically changed, the foam sclerotherapy method being better than that of liquid sclerotherapy.

OBJECTIVES: We have analyzed the immediate pathologic effects on the saphenous vein wall in vivo after sclerotherapy with sodium tetradecyl sulfate (STD) foam.

METHODS: A group of six patients affected by chronic venous insufficiency, operated on by stripping of the saphenous vein, underwent an intraoperative procedure of sclerotherapy to an isolated but not yet removed tract of saphenous vein with 3% STD foam.

RESULTS: The pathologic damage of the foam was extremely rapid with complete damage of the endothelium within the first 2 minutes. In the successive 15 and 30 minutes there was edema of the intimal with its progressive separation from the tunica media and the initial formation and adhesion of the thrombus to the tunica media.

CONCLUSIONS: In this in vivo report we analyze the capacity of 3% STD foam sclerotherapy to damage the saphenous vein wall. The damage is extremely fast and shows the detachment of the intimal and the development of the microthrombus.